Abstract: |
PURPOSE: To determine the frequency with which ultrasonographically (US) guided core biopsy obviated diagnostic surgical biopsy of nonpalpable breast masses, to calculate the cost savings of diagnosis attributable to US-guided core biopsy, and to compare the costs of US-guided versus stereotactically guided core biopsy. MATERIALS AND METHODS: US-guided core biopsy was performed in 151 consecutive solitary, nonpalpable breast masses in 151 women (age, range, 23-80 years) by using a 14-gauge automated gun and needle. Clinical follow-up data were obtained. Cost savings were assessed by using national Medicare reimbursement costs of $385 for US-guided core biopsy, $610 for stereotactic core biopsy, and $1,332 for needle localization and surgical biopsy. RESULTS: US-guided core biopsy obviated a surgical procedure in 128 (85%) of 151 women. The mean adjusted direct cost saving per US-guided core biopsy was $744 per case. Use of US-guided biopsy decreased the cost of diagnosis by 56% ($744/$1,332) over the cost of surgical biopsy. If biopsy had been performed with stereotactic rather than with US guidance, the mean adjusted direct cost saving would have been $519 per case, a 39% ($519/$1,332) decrease in the cost of diagnosis compared with the cost of surgical biopsy. CONCLUSION: Percutaneous biopsy of a nonpalpable breast mass with either US or stereotactic guidance is less expensive than surgery, but cost savings are greater with US-guided biopsy. |
Keywords: |
adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; breast; echomammography; breast neoplasms; biopsy; cost control; cost effectiveness analysis; diagnostic value; breast tumor; cost-benefit analysis; breast biopsy; cost savings; breast diseases; stereotaxic surgery; precancerous conditions; ultrasonography, mammary; humans; human; female; priority journal; article; breast neoplasms, diagnosis; breast, biopsy; stereotaxis; biopsies, technology; ultrasound (us), guidance
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