SHARE

Beware The Gray Areas Of New Breast Biopsy Report, Warns Stamford Doctor

STAMFORD, Conn. -- As Breast biopsies were in the news last week, a doctor at Stamford Hospital warned the information could be misleading. 

Dr. Helen A. Pass, Chief of Breast Surgery at Stamford Hospital.

Dr. Helen A. Pass, Chief of Breast Surgery at Stamford Hospital.

Photo Credit: Submitted

A recent article in the New York Times (go here for story) reports on a new study from The Journal of the American Medical Association (JAMA) that says breast biopsies are good at telling the difference between healthy tissue and cancer, but less reliable for identifying more subtle abnormalities.

According to the study, women whose results fall into the gray zone between normal and malignant — with diagnoses such as “atypia” or “ductal carcinoma in situ” — should seek second opinions. Researchers say misinterpretation can lead women to have surgery and other treatments they do not need, or to miss out on treatments they do need.

These ideas challenge the common belief that a biopsy will, in itself, resolve any questions that might arise from an unclear mammogram or ultrasound.

But, according to Dr. Helen A. Pass, co-director of the Women’s Breast Center and Chief of Breast Surgery at Stamford Hospital, the New York Times article could be somewhat misleading.  

"When I read the JAMA report, I thought two things," she said. "First, this issue has long been recognized as an area of interest. And second, when experts say something is a cancer they normally agree. When they say it’s not a cancer, they agree. But cancer appears on a spectrum, it's like when your bathwater goes from hot to cold. Not everyone agrees on what's warm and so that's the problem with atypia or ductal carcinoma in situ. It can be subjective." 

It's these kind of judgment calls that have made the team at Stamford Hospital so focused on each patient’s particular condition, collaborating to create the most appropriate treatment plan. 

Any cancer diagnosis is automatically sent to a second pathologist who evaluates it “blind” – with no idea of the initial diagnosis – to confirm the original report.

For those tissues that come back atypical, the hospital also has a benign tumor conference every week with pathologists, breast surgeons and radiologist who review all suspect cases to ensure everything was appropriately biopsied and evaluated microscopically – and that the discussion aligns and everyone is in agreement. 

The hospital was the first in the world to be recognized by the American College of Surgeons as a National Accreditation Program for Breast Centers (NAPBC) facility. It was recently re-accredited for another three years and the tumor conference noted as a best practice.

All of which leads back to the JAMA report. Said Dr. Pass: "When I initally looked at the New York Times piece I thought, 'Wow,' they really missed an opportunity to explain what can be somewhat of a gray area."

to follow Daily Voice Fairfield and receive free news updates.

SCROLL TO NEXT ARTICLE