Pathologists Say Certain Tests for Noninvasive Breast Cancer Patients Waste Millions

Pathologists Say Certain Tests for Noninvasive Breast Cancer Patients Waste Millions
Routine management of patients diagnosed with ductal carcinoma in situ (DCIS), the most common type of non-invasive breast cancer, typically includes a needle biopsy to determine if the tumor is invasive or non-invasive and to test for estrogen receptors (ER) and progesterone receptors (PR). But according to a new study conducted by pathologists from Johns Hopkins University School of Medicine in Baltimore, Md., the ER/PR tests are unnecessary and wasteful. The study, "Reflex Estrogen Receptor (ER) and Progesterone Receptor (PR) Analysis of Ductal Carcinoma In Situ (DCIS) in Breast Needle Core Biopsy Specimens: An Unnecessary Exercise That Costs the United States $35 Million/y," published in The American Journal of Surgical Pathology, suggests that ending the practice could save approximately $35 million per year in the United States alone. In DCIS patients particularly, patients with receptor-positive DCIS respond well to relatively medications, such as tamoxifen, that help prevent DCIS from recurring after surgery. But according to the researchers, five factors suggest that testing needle core biopsies for hormone receptors is basically unnecessary. First, regardless of the results of the core biopsy for estrogen receptors (ER) or progesterone receptors (PR), standard of care for DCIS patients in the U.S. is the next step (second factor) — surgical removal of the suspected breast tissue, either by lumpectomy or mastectomy. In some cases, patients who were firs
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