Breast Clinic, Royal Perth Hospital, Wellington Street, Perth, Western Australia, Australia.
Medical School, University of Western Australia, Perth, Western Australia, Australia.
J Med Imaging Radiat Oncol. 2021 Feb;65(1):7-14. doi: 10.1111/1754-9485.13102. Epub 2020 Oct 7.
To evaluate current use of breast biopsy markers (BBM) amongst Australian and New Zealand radiologists.
Radiologists attending a national breast conference were invited to complete an online survey addressing demographics, BBM use following ultrasound, stereotactic, tomosynthesis and MRI-guided biopsy, frequency of early BBM displacement, preoperative lesion localisation (PLL) and axillary BBM use.
Overall response rate was 52% (60/115). The majority (n = 45) 75% practiced in Australia. 98% had BBMs available in their practice, 40% reported BBM costs weren't covered by insurance. 27% would use BBMs more often if they were, with some utilising smaller gauge devices for lesion sampling to minimise need for BBM use and patient out-of-pocket costs. Ultrasound-guided procedures were associated with lower rates of clinically significant BBM displacement (P = 0.001). Considering PLL, 44% were able to perform US-guided PLL in <25% of cases. Poor sonographic visibility was the commonest reason why this wasn't possible. In the axilla, BBMs were mainly used to mark positive nodes in pre-neoadjuvant chemotherapy patients.
This survey is the first to provide data on BBM use amongst a sample of predominantly Australian and New Zealand radiologists, and provides compelling evidence of significantly lower incidence of BBM displacement with US-guided procedures. Our results suggest some radiologists may hesitate to use BBMs due to cost, and this can influence their choice of biopsy technique. Provision of a Medicare item Number for BBMs may lead to increased adoption of best practice guidelines for preoperative diagnosis of breast lesions.
评估澳大利亚和新西兰放射科医生目前对乳腺活检标记物（BBM）的使用情况。
邀请参加全国乳腺会议的放射科医生填写一份在线调查，内容涉及人口统计学、超声引导、立体定向、断层合成和 MRI 引导活检后的 BBM 使用、早期 BBM 移位的频率、术前病变定位（PLL）和腋窝 BBM 使用情况。
总体回复率为 52%（60/115）。大多数（n=45）75%的医生在澳大利亚执业。98%的医生在其诊所中可以使用 BBM，40%的医生报告说 BBM 的费用没有被保险覆盖。如果 BBM 的费用可以得到报销，27%的医生会更频繁地使用 BBM，有些医生会使用更小口径的设备进行病变取样，以尽量减少 BBM 的使用和患者的自费费用。超声引导的操作与临床显著 BBM 移位的发生率较低相关（P=0.001）。考虑到 PLL，44%的医生能够在<25%的情况下进行 US 引导的 PLL。超声无法清晰显示是导致无法进行的最常见原因。在腋窝中，BBM 主要用于标记新辅助化疗前阳性淋巴结。
这项调查是首次提供了澳大利亚和新西兰放射科医生使用 BBM 的数据，并提供了具有说服力的证据，表明超声引导的操作与 BBM 移位的发生率显著降低。我们的结果表明，由于成本的原因，一些放射科医生可能不愿意使用 BBM，这可能会影响他们对活检技术的选择。为 BBM 提供 Medicare 项目编号可能会导致更多地采用术前诊断乳腺病变的最佳实践指南。
