Hazards of biopsy revisited

The hazards of the biopsy, revisited. Members of the Musculoskeletal Tumor Society.

Mankin HJ, Mankin CJ, Simon MA. The Journal of bone and joint surgery. American volume 1996 · PMID 8642021 · doi:10.2106/00004623-199605000-00004

Cohort studyDiagnosisTumoursCitation checked

Question: How often do biopsies of musculoskeletal tumours lead to errors and adverse effects on treatment, and where are they performed?
Design: Multicentre retrospective review by Musculoskeletal Tumor Society members.
Patients: Patients with primary bone and soft tissue sarcomas who underwent biopsy.
Intervention: Biopsy at a referring hospital
Comparison: Biopsy at a specialist treating centre
Primary outcome: Diagnostic errors, complications and change in treatment or outcome
Key result: Biopsy problems (diagnostic errors, complications, altered treatment and unnecessary amputation) were significantly more frequent when biopsy was done at a referring institution than at a treating centre.
Limitations: Retrospective and dependent on reporting by specialist centres, so prone to selection bias.
Impact on practice: Supports the rule that biopsy of a suspected sarcoma should be planned and done by (or with) the treating sarcoma team, with the tract placed so it can be excised.