Purpose: To examine the rate of uptake of percutaneous breast biopsy in a period following generation of evidence that it produces improved patient outcomes.
Methods: We used Medicare Part B data to examine the substitution of percutaneous breast biopsy for open breast biopsy during the period from 2001 to 2008. We looked at the specialties of physicians performing these biopsies and the geographic distribution of percutaneous biopsy by HRR.
Results: During the study period the percentage of core biopsies being performed rose from 44% to 74%. In the final three years we examined, there was geographic variation in the use of core versus open biography, with high use HRRs appearing geographically clustered, and by this time areas performing less than 50% core biopsies having become rare. While much attention has been paid to “turf issues” of surgeons versus radiologists performing procedures slowing the uptake of percutaneous biopsy, we found that while general surgeons performed 80% of open biopsies, they also performed 28% of percutaneous biopsies, with 66% being performed by radiologists.
Conclusions: Published research indicates that approximately 20% of biopsies were open in 2009, showing a continuing adoption trajectory. While adoption of new technologies with proven efficacy does not happen immediately, diffusion of new technologies with demonstrated advantages does take place even when it may require significant changes to practice.
