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

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)