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2009 Annual Meeting Abstracts

Breast Capsulectomy Specimens and Their Clinical Implications
Forrest S. Roth, MD1, John M. Felder, III, BA1, Jeffrey Friedman, MD2.
1Baylor College of Medicine, Houston, TX, USA, 2The Methodist Hospital, Houston, TX, USA.

PURPOSE: To investigate the cost-effectiveness of and necessity for routine submission of breast capsulectomy specimens to pathological analysis
METHODS: A retrospective review of all breast capsule pathology reports from 2000-2008 was undertaken at The Methodist Hospital in Houston, TX. Patients who had undergone capsulectomy were identified by querying the medical records system for CPT codes 19370 and 19371. 264 patients qualified for the study, and these patients' operative and pathology reports were reviewed to determine the indication for capsulectomy and the result of microscopic analysis by pathology.
RESULTS: Of 264 patients reviewed (434 total capsules) all but one were determined benign by pathological analysis. One capsule specimen was found to contain malignancy, in the setting of a patient who was preoperatively known to have clinically apparent widely recurrent breast cancer. This finding did not alter management in any way. %99.6 of patients and %99.7 of capsules reviewed were found to be benign.
The cost per capsule for pathologic review is .00, for a total cost of >,000 for the 434 capsules studied.
CONCLUSION: Pathological information obtained by routine submission of breast capsules for microscopic pathological analysis did not affect medical or surgical treatment in a large sample of capsulectomy patients. There are no indications for the submission of breast capsulectomy specimens in asymptomatic patients undergoing partial or total capsulectomy, and such routine analysis was not found to be cost-effective.


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