Use of breast core biopsy in the United States: Results of a national survey

OBJECTIVE. We analyzed the results of a national survey to determine the current use and practice of breast core biopsy. MATERIALS AND METHODS, A survey was mailed to 1700 members of the Society of Breast imaging who reside in the United States. The questions included frequency of biopsy, specialty of responsible physician, type of guidance used, physician credentialing, method and duration of follow-up, referral patterns, scheduling practices, and types of lesions biopsied. Opinions about the future usefulness of breast core biopsy were solicited, RESULTS. We received 458 responses (27% response rate) from 48 states and the District of Columbia. Eighty-one percent of the respondents indicated that breast core biopsy is performed at their practice or institution; among these, 85% are performed solely by radiologists. Of these performing the procedure, 61% do not have special credentials. Seventy-one percent use both stereotaxic and sonographic guidance. For follow-up after the procedure, patients are tracked manually and by computer in near-equal proportions. The median period of patient follow-up is 12 months; 11% of the respondents track indefinitely. Surgeons and primary care physicians most commonly refer patients for core biopsy. The procedure is most often performed after notification of the referring physician (76%), and 80% of the respondents schedule core biopsy without prior surgical consultation. Masses and calcifications categorized as probably benign to highly suspicious are included as indications for core biopsy. Forty percent of the respondents offer core biopsy on the same visit as when an abnormality is found. Eighty percent of the respondents believe the procedure will increase in use; 48% believe that core biopsy will replace most surgical biopsies for nonpalpable lesions, CONCLUSIONS, Breast core biopsy is widely used in the United States for sampling a broad spectrum of imaging abnormalities. Both sonographic and stereotaxic guidance are commonly used. Credentialing requirements, practice patterns, and follow-up after the core biopsy procedure vary considerably among different sites.