Hospitals waste millions on needle biopsies for noninvasive breast cancer, researchers say

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Initial hormone receptor tests for patients with the most common type of noninvasive breast cancer are not only unnecessary but could be costing U.S. hospitals tens of millions of dollars per year in wasted costs, according to Johns Hopkins University School of Medicine researchers in Baltimore.

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"If you apply our local results nationally, these unnecessary initial hormone receptor tests currently come with an annual price tag of around $35 million," Pedram Argani, MD, senior author of a study published in the American Journal of Surgical Pathology, said in a statement. "Our results indicate that's an expense without any justification. If these tests were routinely eliminated, the savings would be substantial."

Thousand of routine estrogen and progesterone receptor tests, taken via needle biopsy, are performed every year under a local anesthetic. The rationale for these tests, Dr. Argani said, is that they help determine which patients can take certain medications after excision that block receptors to prevent cancer from recurring. But the biopsy results don't affect the therapy patients will receive, as it is standard practice to surgically remove breast tissue remaining in the suspect area, according to the authors.

Based on the research, The Johns Hopkins Hospital ended the practice of routine core needle biopsy hormone receptor testing in January. 

The annual costs of biopsy and automatic testing for the 60,000 U.S. patients diagnosed with DCIS — the common type of breast cancer — are what add up to an estimated cost in the tens of millions of dollars, according to the authors. 

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