Patients with ductal carcinoma in situ (DCIS) breast cancer don't need hormone receptor testing with core needle biopsy, according to research published in the August issue of the American Journal of Surgical Pathology.
The rationale behind these tests has been that patients with hormone receptor-positive DCIS after excision can take medications such as tamoxifen to block the receptors and help prevent DCIS from recurring, wrote a group led by Dr. Pedram Argani of Johns Hopkins University.
But regardless of the test results, the standard of care in the U.S. after needle biopsy for DCIS is that breast tissue still remaining in the suspect area is surgically removed by lumpectomy or mastectomy -- which means that the core biopsy hormone receptor results do not affect therapy, according to Argani and colleagues (Am J Surg Pathol, August 2016, Vol. 40:8, pp. 1090-1099).
For their study, the researchers reviewed the pathology and medical records of 58 patients newly diagnosed with DCIS who had core needle biopsies and follow-up excision over a two-year period beginning in January 2011. They found that two-thirds of the patients did not receive hormone therapy, even after excision confirmed their hormone receptor-positive DCIS status.
Argani's group estimated that these unnecessary tests cost the healthcare system about $35 million per year.
"The millions saved could save 9,000 children and adults from dying of malaria worldwide, or provide 61,000 hungry American families a year's food," the researchers concluded.
