title: Selective use of image-guided large-core needle biopsy of the breast: accuracy and cost-effectiveness.
abstract: OBJECTIVE
  We examined the accuracy and cost-effectiveness of large-core needle breast biopsy in a selected group of patients with mammographically detected lesions.
  
  
  METHODS
  We selectively used large-core needle biopsy to sample breast lesions that were intermediate (neither clearly benign nor clearly malignant) and wire localization biopsy to sample breast lesions that were strongly suggestive of cancer. We compared 2 years' experience using this protocol with the preceding 2 years at the University of Utah Health Sciences Center during which we did only a few large-core needle biopsies on a nonselective basis.
  
  
  RESULTS
  Our biopsy rate increased from one biopsy per 36 mammographic screening examinations to one per 26 (p = .001) when the protocol was used. The cost of biopsy per cancer detected decreased from $11,555 to $8356. The specificity of large-core needle biopsy was 98%; the sensitivity based on limited follow-up was 100%.
  
  
  CONCLUSIONS
  Large-core needle biopsy is an accurate and cost-effective method for sampling breast lesions when used in a selective fashion.
authors.affiliation: Radiology Department, University of Utah Health Sciences Center, Salt Lake City 84132.
authors.forename: A J
authors.initials: AJ
authors.lastname: Doyle
authors.forename: K A
authors.initials: KA
authors.lastname: Murray
authors.forename: E W
authors.initials: EW
authors.lastname: Nelson
authors.forename: D G
authors.initials: DG
authors.lastname: Bragg
mesh_terms: D000704:Analysis of Variance; D001707:Biopsy, Needle / Q000191:economics / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000191:economics / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000191:economics / Q000473:pathology; D016009:Chi-Square Distribution; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography / Q000191:economics / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity