Calcifications highly suggestive of malignancy: Comparison of breast biopsy methods Journal Article


Authors: Liberman, L.; Gougoutas, C. A.; Zakowski, M. F.; Latrenta, L. R.; Abramson, A. F.; Morris, E. A.; Dershaw, D. D.
Article Title: Calcifications highly suggestive of malignancy: Comparison of breast biopsy methods
Abstract: OBJECTIVE. The purpose of this study was to compare the usefulness of, and cost of diagnosing with, different breast biopsy methods for women with calcifications highly suggestive of malignancy. MATERIALS AND METHODS. One hundred thirty-nine women with calcifications highly suggestive of malignancy underwent diagnostic biopsy. Of these, 89 women had stereotactic biopsy with a 14-gauge automated needle (n = 25), 14-gauge vacuum-assisted probe (n = 17), or 11-gauge vacuum-assisted probe (n = 47); and 50 women had diagnostic surgical biopsy. Medical records were reviewed. Cost savings for stereotactic biopsy were calculated using Medicare data. RESULTS. The median number of operations was one for women who had stereotactic biopsy versus two for women who had diagnostic surgical biopsy. The likelihood of undergoing a single operation was significantly greater for women who had stereotactic rather than surgical biopsy, among all women (61/89 [68.5%] vs. 19/50 [38.0%], p < 0.001) and among women treated for breast cancer (55/77 [71.4%] vs. 6/37 [16.2%], p = 0.0000001). Stereotactic 11-gauge vacuum-assisted biopsy, as compared with 14-gauge automated core or 14-gauge vacuum-assisted biopsy, was significantly more likely to spare a surgical procedure (36/47 [76.6%] vs. 16/42 [38.1%], p = 0.0005). Stereotactic 11-gauge vacuum-assisted biopsy resulted in the greatest cost reduction, yielding savings of $315 per case compared with diagnostic surgical biopsy; for women with solitary lesions, stereotactic 11-gauge biopsy decreased the cost of diagnosis by 22.2% ($334/$1502). CONCLUSION. For women with calcifications highly suggestive of malignancy, the use of stereotactic rather than surgical biopsy decreases the number of operations. Stereotactic 11-gauge vacuum-assisted biopsy, as compared with 14-gauge automated core or 14-gauge vacuum-assisted biopsy, is significantly more likely to spare a surgical procedure and has the highest cost savings.
Keywords: adult; aged; aged, 80 and over; middle aged; major clinical study; cancer diagnosis; breast cancer; diagnosis, differential; breast neoplasms; biopsy; cost control; medicare; medical record; intermethod comparison; breast biopsy; costs and cost analysis; breast diseases; stereotaxic surgery; calcinosis; breast calcification; humans; human; female; priority journal; article
Journal Title: American Journal of Roentgenology
Volume: 177
Issue: 1
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2001-07-01
Start Page: 165
End Page: 172
Language: English
PUBMED: 11418420
PROVIDER: scopus
DOI: 10.2214/ajr.177.1.1770165
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
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MSK Authors
  1. D David Dershaw
    223 Dershaw
  2. Laura Liberman
    176 Liberman
  3. Elizabeth A Morris
    341 Morris
  4. Maureen F Zakowski
    289 Zakowski