title: The palpable breast nodule. A cost-effectiveness analysis of alternate diagnostic approaches.
abstract: BACKGROUND
  Traditionally, open biopsy has been considered the optimal procedure for the diagnosis of breast nodules. Fine-needle aspiration biopsy (FNAB) has been proposed as an alternate method for the diagnosis of many palpable breast lesions.
  
  
  METHODS
  The authors compared the diagnostic utility of open biopsy and FNAB using decision tree and cost-effectiveness analyses.
  
  
  RESULTS
  When compared with two-step excisional biopsy, FNAB achieved a savings of over $700 at the cost of 0.1% decrease in 10-year overall survival.
  
  
  CONCLUSIONS
  These data indicate FNAB to be a reasonable alternative to open biopsy for the diagnosis of palpable breast lesions in many patients.
authors.affiliation: Department of Pathology, Duke University Medical Center, Durham, NC 27705.
authors.forename: L J
authors.initials: LJ
authors.lastname: Layfield
authors.forename: E A
authors.initials: EA
authors.lastname: Chrischilles
authors.forename: M B
authors.initials: MB
authors.lastname: Cohen
authors.forename: K
authors.initials: K
authors.lastname: Bottles
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000191:economics; D001706:Biopsy / Q000191:economics / Q000379:methods; D001707:Biopsy, Needle / Q000191:economics / Q000379:methods; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000601:surgery; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003661:Decision Support Techniques; D003663:Decision Trees; D005260:Female; D005629:Frozen Sections / Q000191:economics; D006801:Humans; D007430:Intraoperative Care / Q000191:economics; D008017:Life Expectancy; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D015996:Survival Rate; D013727:Terminal Care / Q000191:economics