The current practice of open neck mass biopsy in the diagnosis of head and neck cancer: A retrospective cohort study

Abstract

Objective To characterize current use of open neck mass biopsy for diagnosis of squamous cell carcinoma in patients presenting with a neck mass. Methods Using the University of Michigan Specialized Program of Research Excellence in Head and Neck Cancer patient database (2008–2014), we reviewed patients’ referral documentation to identify those who received open neck mass biopsies as part of their squamous cell carcinoma diagnosis. We compared subsequent treatment between patients who did and did not receive an open neck mass biopsy. Results Of 940 patients, 50 patients had received open neck mass biopsy leading to squamous cell carcinoma diagnosis. Only 19 of 50 patients (38%) had undergone fine‐needle aspiration prior to open neck mass biopsy. There were no statistically significant differences in treatment or outcomes between patients who did and those who did not receive open neck mass biopsy. Conclusion Optimal care for patients who present with a neck mass is fine‐needle aspiration. Unfortunately, these data show that many patients undergo open neck mass biopsy for diagnosis, often without prior fine‐needle aspirate. Compared to fine‐needle aspiration, open biopsy incurs additional risks of general anesthesia and greater surgical risks. While our data did not find statistically significant differences between treatment offered and outcomes, this small study was not expected to demonstrate a difference in outcomes. Further work is needed to promote the utility of fine‐needle aspiration for diagnosis of neck mass and to discourage use of open neck mass biopsy as a primary diagnostic intervention. Level of Evidence 2c (Outcomes Research)

Lateral cystic neck masses in adults: a ten-year series and comparative analysis of diagnostic modalities

“…Several studies have demonstrated no impact on survival when excision biopsy is performed on a solitary neck node prior to radical radiotherapy. [25][26][27] Indeed, the combined 5-year overall survival in this series, including the oropharyngeal and unknown primary cases, was 87.5 per cent, comparing favourably with our published outcomes for all HPV positive and negative SCC (83 per cent and 53 per cent, respectively), 28 which is reassuring. However, we hope that optimisation of the investigation strategy will help improve our pre-open biopsy diagnostic rate and potentially help to reduce the overall pathway time by reducing uncertainty regarding investigations.…”

Diagnostic performance of core needle biopsy for nodal recurrences in patients with head and neck squamous cell carcinoma

“…Previously, US-guided CNB has been reported as an effective, inexpensive, time-efficient, safe, and minimally invasive diagnostic tool for neck nodal disease 11 , 12 . According to previous reports, the sensitivity, specificity, and accuracy of CNB for neck masses were about 99.7%, 100% and 99.46%, respectively 13 , 14 .…”

How Medically Favorable Is the Replacement of the Invasive Colonoscopy With Cologuard Non-Invasive Colorectal Cancer Screening?

“…This data collection is approved for studies involving anything from cesarean section complications to head and neck cancer diagnoses. 15,16 Due to the fact that the restrictions of the AP course did not make a randomized controlled trial feasible as a study type, not all statistics regarding the Cologuard test could be analyzed. Though it would have been preferable to conduct a statistical analysis with both sensitivity and specificity, determining specificity from secondary data collected in the past is not possible.…”