US-guided core breast biopsy: use and cost-effectiveness.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Breast Imaging Section, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
L
L
Liberman
T L
TL
Feng
D D
DD
Dershaw
E A
EA
Morris
A F
AF
Abramson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000191:economics*; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000191:economics / Q000473:pathology; D001943:Breast Neoplasms / Q000191:economics / Q000473:pathology; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D011230:Precancerous Conditions / Q000191:economics / Q000473:pathology; D016217:Ultrasonography, Mammary / Q000191:economics*