How to avoid unnecessary biopsy in breast imaging: the Tayside experience

There are considerable benefits to be gained from biopsying fewer lesions at breast imaging. These include preventing patient discomfort, saving radiologist/advanced practitioner time hence improving clinic throughput, saving pathology time, preventing patient anxiety while waiting for the result and saving multidisciplinary team meeting time. These benefits do need to be balanced against the tragedy of delayed diagnosis of malignancy if this approach is taken too far, and also take into account the low morbidity associated with breast biopsy. Benign biopsy is, however, associated with short-term anxiety that tends to reoccur during later screening episodes. Changes in practice do not imply incorrect practice in the past, but that our understanding of breast disease and how it is managed changes with time, and breast radiology practice needs to change to reflect these new priorities.

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