Accession Number:

ADA371488

Title:

Diagnostic Strategies for Breast Cancer: Optimizing the Tradeoffs.

Descriptive Note:

Final rept. 1 Sep 94-30 Apr 99

Corporate Author:

AMERICAN COLL OF PHYSICIANS PHILADELPHIA PA

Personal Author(s):

Report Date:

1999-05-01

Pagination or Media Count:

84.0

Abstract:

This is the final report for the Diagnostic Strategies for Breast Cancer grant. From over 6000 citations, we have abstracted and analyzed 85 articles involving over 27,000 patients, fine needle aspirates and breast biopsies for the evaluation of breast lesions. Our meta-analysis, the largest performed to date, suggests that fine needle aspiration has a sensitivity and specificity that ranges from 79.3 to 92.4 and from 85.7 to 99.1 depending on whether results for suspicious or atypical cytology are classified as positive. Our decision analysis comparing fine needle aspiration to open biopsy differs from nearly all prior analyses by considering the long-term costs of care for breast cancer and the economic and clinical effects of a possible delay in diagnosis resulting from false negative cytology results. Our results suggest that open biopsy may be cost-effective because of cost savings and lives saved from fewer false negative cytology results. The likelihood of breast cancer, the likelihood of a delayed diagnosis resulting in a more advanced stage of breast cancer all affected the results.

Subject Categories:

  • Anatomy and Physiology
  • Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE