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According to a new study, breast tissue biopsies are frequently misdiagnosed, so you might want to get a second medical opinion. The paper was published in the Journal of the American Medical Association (JAMA).
According to the study, pathologists are very good at diagnosing cancerous samples but have difficulties when examining normal biopsied tissue or when the condition is minor. This can lead to patients going through treatments that are too aggressive for some or too weak thus ineffective for others.
Approximately 1.6 million biopsied breast tissue samples are taken after radiologists detect something abnormal on a mammogram. The biopsy is conducted through a needle or surgically then sent to microscopic analysis. Previous research has shown that mammograms are difficult to interpret and can result in insufficient or unnecessarily aggressive treatment.
There were 115 U.S. pathologists participating in the research and 240 breast biopsy specimens. Their diagnoses were compared to those set by three experts. Although the situation might not occur in real life conditions, the team says findings show how difficult it is to accurately interpret biopsied tissue under a microscope.
Results showed that abnormal tissue was correctly diagnosed by pathologists 50 percent of time, a rather grim conclusion. A third of the samples were misdiagnosed as “normal” and 13 percent were considered suspicious, although they were actually normal tissue samples.
Lead author Dr. Joann Elmore from the University of Washington explains that since approximately 160,000 U.S. women are annually diagnosed with breast cancer, the study shows that many of them might have received inappropriate treatment.
Similar results were obtained in the case of a condition called DCIS. In 3 percent of cases, samples were misdiagnosed as invasive cancer while 13 percent of cases were considered less serious than they actually were. DCIS is a condition where abnormal cells develop in the milk duct. Each year, about 60,000 women in the U.S. are diagnosed with DCIS and the number of cases has risen due to an increase in mammogram use. As the abnormal cells have a potential of spreading, the usual treatment involves and radiation.
Another JAMA article stated that the study is missing data regarding patient outcomes so there is no evidence that the experts actually made a correct diagnosis. Furthermore, pathologists weren’t allowed to consult other specialists when in doubt.
Still, the editorial says the study’s results “should be a call to action for pathologists and breast cancer scientists”.
Image Source: TIME
