Plastic and single-use materials in breast cancer screening and diagnosis: A multi-center audit of modifiable resource use in oncology care.

Abstract

e23159 Background: Breast cancer screening and diagnostic pathways are central to modern oncology care and rely on imaging, biopsy, and pathology workflows. These processes are increasingly resource-intensive and generate substantial single-use material waste, much of which is plastic-based. Plastics and waste-associated pollutants are implicated in environmental exposures relevant to cancer risk and public health. Quantifying material use within routine diagnostic workflows is a necessary first step toward identifying high-value opportunities to reduce unnecessary waste while preserving diagnostic quality and patient outcomes. Methods: We conducted a multicenter audit at three U.S. academic medical centers of materials in common breast cancer diagnostic steps, including ultrasound-guided (USG) fine-needle aspiration (FNA), stereotactic core-needle biopsy (CNB), USG CNB, MRI-guided (MRIG) CNB, and pathology processing of CNB and FNA samples. Per process step, supplies were cataloged by recording primary material composition, mass, and whether the item was single-use. We quantified the proportion and mass of plastic and single-use materials and compared consumption across diagnostic steps. Results: Plastic was the primary material in 27–50% of supplies used across biopsy modalities, while single-use items comprised the majority of supplies across evaluated steps (61–81%). Although plastics accounted for a smaller proportion of total material mass (4–16%), single-use items represented up to 27% of total material mass per process step. Stereotactic CNB had the highest total material mass per process step (7,255 g) but the lowest proportion of plastic by mass (4%). USG CNB had the highest plastic mass per biopsy step (410 g). Pathology processing of FNA specimens contributed substantial plastic mass (530 g). Conclusions: Breast cancer diagnostic workflows depend on single-use and plastic-based materials across imaging, biopsy, and pathology steps, which contribute to downstream harmful environmental pollutants. Our results identify clinically-relevant opportunities to reduce such material consumption. Integrating waste-reduction strategies into breast cancer screening and diagnostic pathways may help align high-quality oncologic care with critical environmental risk reduction. Process Step Supplies per Step (SpS) (n) % Plastic SpS (n) % Single-Use SpS (n) Total Mass of SpS (g) Mass of Single-Use SpS (g) Single-Use Mass pS (%) Mass of Plastic Material in SpS (g) Plastic Mass pS (%) USG FNA 18 50.0 61.1 2,460 242.4 9.9 393 16.0 Stereotactic CNB 20 45.0 80.0 7,255 1067.6 14.7 314 4.3 USG CNB 20 50.0 70.0 3,020 802.9 26.6 410 13.6 MRIG CNB 15 26.6 73.3 2,043 89.7 4.4 330 16.1 CNB Pathology 25 20.0 64.0 — — — 62 — FNA Pathology 26 23.1 80.8 — — — 530 — Mean ± SD — 42.9 ± 11.1 71.1 ± 7.3 3,944 ± 2,222 505.1 ± 407 13.9 ±9.5 362 ± 44 9.2 ± 2.1