Gradual adoption of needle biopsy for breast lesions in a rural state

Abstract Background Minimally invasive breast biopsy (MIBB) is the standard of care for the diagnosis of breast cancer, with consensus guidelines suggesting MIBB goals of 90% of total biopsies. In a previous study of patients in the rural state of Vermont, USA (population size of 640,000), rural bre...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Serena Murphy, Yi‐Chuan Yu, Colleen Kerrigan, Brian Sprague, Michelle Sowden
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	breast cancer needle biopsy population quality improvement standard of care Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/175594470bdc4dcaa4cf606a97d72092
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:175594470bdc4dcaa4cf606a97d72092
record_format	dspace
spelling	oai:doaj.org-article:175594470bdc4dcaa4cf606a97d720922021-12-01T04:49:14ZGradual adoption of needle biopsy for breast lesions in a rural state2045-763410.1002/cam4.4282https://doaj.org/article/175594470bdc4dcaa4cf606a97d720922021-12-01T00:00:00Zhttps://doi.org/10.1002/cam4.4282https://doaj.org/toc/2045-7634Abstract Background Minimally invasive breast biopsy (MIBB) is the standard of care for the diagnosis of breast cancer, with consensus guidelines suggesting MIBB goals of 90% of total biopsies. In a previous study of patients in the rural state of Vermont, USA (population size of 640,000), rural breast cancer patients had open biopsies 42% of the time compared to 29% of urban breast cancer patients. The aim of this study was to assess overall population‐based biopsy trends in Vermont. Methods The Vermont Breast Cancer Surveillance System (VBCSS) was used to identify women receiving MIBB and excisional breast biopsies in Vermont. Patient zip code at the time of initial biopsy was used to determine the patient residence rurality by rural–urban commuting area codes (RUCA 2.0™). Results There were 9122 diagnostic episodes from 1999 to 2018. MIBB was the initial biopsy method in 7524 (82.5%) cases, while surgical excision was the initial biopsy method in 1598 (17.5%) cases. A linear trend fit estimated an increase of 1.3% per year (p < 0.001, 95% CI 1.1%–1.5%) in the fraction of patients undergoing MIBB. Patients living in rural areas were less likely to receive MIBB (78.5%) than those living in urban areas (94.9%), p < 0.001. Multivariate analysis showed that urban patients and those patients in the years 2014–2018 were more likely to receive MIBB (OR 5.00, 95% CI 4.13–6.05 [p < 0.05] and OR 4.41, 95%CI 3.68–5.28 [p < 0.05], respectively). The rate of MIBB for rural patients increased and met the 90% quality standard in 2013 and ultimately matched urban patient rates of MIBB in 2018. Conclusions For the first time, we show that MIBB usage is above 90% in the state of Vermont and that there no longer exist disparities in breast biopsies between urban and rural patients or rural/urban facilities in the state, overall.Serena MurphyYi‐Chuan YuColleen KerriganBrian SpragueMichelle SowdenWileyarticlebreast cancerneedle biopsypopulationquality improvementstandard of careNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Medicine, Vol 10, Iss 23, Pp 8320-8327 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	breast cancer needle biopsy population quality improvement standard of care Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	breast cancer needle biopsy population quality improvement standard of care Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Serena Murphy Yi‐Chuan Yu Colleen Kerrigan Brian Sprague Michelle Sowden Gradual adoption of needle biopsy for breast lesions in a rural state
description	Abstract Background Minimally invasive breast biopsy (MIBB) is the standard of care for the diagnosis of breast cancer, with consensus guidelines suggesting MIBB goals of 90% of total biopsies. In a previous study of patients in the rural state of Vermont, USA (population size of 640,000), rural breast cancer patients had open biopsies 42% of the time compared to 29% of urban breast cancer patients. The aim of this study was to assess overall population‐based biopsy trends in Vermont. Methods The Vermont Breast Cancer Surveillance System (VBCSS) was used to identify women receiving MIBB and excisional breast biopsies in Vermont. Patient zip code at the time of initial biopsy was used to determine the patient residence rurality by rural–urban commuting area codes (RUCA 2.0™). Results There were 9122 diagnostic episodes from 1999 to 2018. MIBB was the initial biopsy method in 7524 (82.5%) cases, while surgical excision was the initial biopsy method in 1598 (17.5%) cases. A linear trend fit estimated an increase of 1.3% per year (p < 0.001, 95% CI 1.1%–1.5%) in the fraction of patients undergoing MIBB. Patients living in rural areas were less likely to receive MIBB (78.5%) than those living in urban areas (94.9%), p < 0.001. Multivariate analysis showed that urban patients and those patients in the years 2014–2018 were more likely to receive MIBB (OR 5.00, 95% CI 4.13–6.05 [p < 0.05] and OR 4.41, 95%CI 3.68–5.28 [p < 0.05], respectively). The rate of MIBB for rural patients increased and met the 90% quality standard in 2013 and ultimately matched urban patient rates of MIBB in 2018. Conclusions For the first time, we show that MIBB usage is above 90% in the state of Vermont and that there no longer exist disparities in breast biopsies between urban and rural patients or rural/urban facilities in the state, overall.
format	article
author	Serena Murphy Yi‐Chuan Yu Colleen Kerrigan Brian Sprague Michelle Sowden
author_facet	Serena Murphy Yi‐Chuan Yu Colleen Kerrigan Brian Sprague Michelle Sowden
author_sort	Serena Murphy
title	Gradual adoption of needle biopsy for breast lesions in a rural state
title_short	Gradual adoption of needle biopsy for breast lesions in a rural state
title_full	Gradual adoption of needle biopsy for breast lesions in a rural state
title_fullStr	Gradual adoption of needle biopsy for breast lesions in a rural state
title_full_unstemmed	Gradual adoption of needle biopsy for breast lesions in a rural state
title_sort	gradual adoption of needle biopsy for breast lesions in a rural state
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/175594470bdc4dcaa4cf606a97d72092
work_keys_str_mv	AT serenamurphy gradualadoptionofneedlebiopsyforbreastlesionsinaruralstate AT yichuanyu gradualadoptionofneedlebiopsyforbreastlesionsinaruralstate AT colleenkerrigan gradualadoptionofneedlebiopsyforbreastlesionsinaruralstate AT briansprague gradualadoptionofneedlebiopsyforbreastlesionsinaruralstate AT michellesowden gradualadoptionofneedlebiopsyforbreastlesionsinaruralstate
_version_	1718405710242381824

Gradual adoption of needle biopsy for breast lesions in a rural state

Ejemplares similares