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Shedding Light on the Breast Biopsy Process

What You Need to Know to Avoid a Misdiagnosis

By Dr. Andrew Kenler

Breast cancer is the second most common cancer among women in the United States and tends to get a lot of atention in October during Breast Cancer Awareness Month. While raising awareness of the disease and promoting prevention are of utmost importance, oſten there is litle light shed upon the sometimes scary and overwhelming process that patients go through when being diagnosed with breast cancer, and the steps they can take to arm themselves throughout the process.

Te most common method used to detect breast cancer is a mammogram, typically performed once a year in women over the age of 40. As a result of routine mammography screening, approximately 1.6 million biopsies are performed to determine whether a suspicious lump or mass is cancerous or benign (non-cancerous). During a breast biopsy the physician obtains a microscopic tissue sample of the mass that is then sent to a laboratory and tested. However, what happens aſter the biopsy sample is collected is essential to the process of ensuring that the patient receives the right diagnosis.

Many patients are unaware that aſter their physician takes a biopsy sample, the tissue sample moves through a complex 18-step process to determine whether cancerous cells are present and, if so, what stage of cancer is present. With such a complex process executed on a large scale, the risk of patient’s samples being misidentified due to mislabeling, switching or contamination is alarming. Tese errors occur in approximately 1 in every 100 surgical biopsies performed in the U.S. If leſt undetected, these mistakes can lead to misdiagnoses and patients receiving treatment for cancer they do not have or in the delay of life-saving treatment in patients with cancer.

Recently I learned of a case where a woman received six radiation treatments before learning she had been incorrectly diagnosed with breast cancer. Te misdiagnosis was the result of a laboratory error in which her biopsy was contaminated with another patient’s cancerous samples. Tese cases have a profound impact on the physical and emotional well-being of multiple patients, not to mention significant legal and financial ramifications as well.

26 October 2012

To prevent these types of issues and help ensure that the correct biopsy diagnoses are provided to the correct patients, physicians like myself have begun using the know error® system for breast biopsies. Tis system incorporates a DNA test to confirm that the cancerous biopsy sample matches the patient receiving the diagnosis. Simply put, the know error system helps us to know with 100 percent certainty that when we tell a patient she has cancer, we are telling the correct patient.

Here’s how the system works: At the time of the biopsy, the physician obtains a painless cheek swab to serve as a reference sample of the patient’s DNA. If cancer is detected in biopsy sample, the DNA of the cancerous mass is then compared against the DNA in the supplied cheek swab to ensure that the results are reported to the correct individual. Tis confirmation ensures the identity of the patient being diagnosed, allowing physicians to proceed confidently with treatment recommendations.

If you or a loved one is going through this difficult process, talk to your physician about steps that can be taken to ensure you receive your confirmed biopsy results. With the emotional, life-changing impact a cancer diagnosis has on an individual it’s important to ensure that no woman incorrectly hears the four dreaded words—you have breast cancer.

Dr. Andrew S. Kenler is a board certified General Surgeon practicing at Bridgeport Hospital and an Assistant Clinical Professor of Surgery at Yale Medical School. He earned his medical degree from Cornell University Medical College in New York City, and completed his surgery training at the prestigious New England Deaconess Hospital, part of the Harvard Medical School system in Boston, Massachusets. He is well known for his expertise in expertise in the use of image guidance (ultrasound and digital mammography) to diagnose and treat benign and malignant breast disease and oncoplastic surgery of the breast.

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