[Cost-effectiveness of percutaneous core needle breast biopsy (CNBB) versus open surgical biopsy (OSB) of nonpalpable breast lesions: metaanalysis and cost evaluation for German-speaking countries].
OBJECTIVE
To analyze the cost-effectiveness of percutaneous image-guided CNBB (stereotactic-/ultrasound-guided; large/vacuum-assisted) of non-palpable breast lesions vs. OSB and to compare and discuss the results reported in the literature with results for German-speaking countries.


METHODS
A key word search in three databases, limited to the period from 1/1994 to 12/2006 was performed. Only original papers were selected. No published articles for German-speaking countries were identified; therefore a comprehensive data collection was made.


RESULTS
On the basis of 377 abstracts, nine studies were evaluated for final assessment. The data of German-speaking countries were compared with results reported in the literature. This study demonstrates that CNBB compared to OSB leads to reduction in cost ranging from 51-96 %. The cost reduction depends on biopsy modality and lesion type and is subject to national fluctuations. CNBB can replace a surgical procedure in 71-85 % of cases.


CONCLUSIONS
Use of CNBB as an alternative to OSB has the potential to substantially reduce healthcare costs. The data are based almost exclusively on the North American literature. A potential cost reduction in the Netherlands and Switzerland confirms these findings. Future work must include cost evaluation studies for German-speaking countries since this is an issue with important national economic ramifications.
Klinik für Radiodiagnostik, Medizinische Universität Wien, Währinger Gürtel 18-20, Vienna. renate.gruber@wgkk.sozvers.at
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D001707:Biopsy, Needle / Q000191:economics* / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000473:pathology*; D003362:Cost-Benefit Analysis; D005060:Europe / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D010173:Palpation; D018084:Ultrasonography, Interventional / Q000191:economics* / Q000706:statistics & numerical data