Impact of stereotactic 11-g vacuum-assisted breast biopsy on cost of diagnosis in Austria.
OBJECTIVE
To determine the frequency with which stereotactic 11-g vacuum-assisted breast biopsy (11-g SVAB) obviates an open surgical biopsy (OSB), to compare the costs of these two biopsy methods, and to estimate the potential cost savings attributable to 11-g SVAB in the diagnosis of suspicious breast lesions in patients in Austria.


METHODS
We retrospectively reviewed 318 consecutive breast lesions of BI-RADS categories IV and V (microcalcifications n=166; masses n=152) on which 11-g SVAB and OSB were performed. Cost savings were calculated using nationally allowed flat rates and patient charges. Costs were measured from a hospital and a socioeconomic perspective. Common clinical scenarios and sensitivity analyses assessed the extent of achievable cost savings.


RESULTS
11-g SVAB obviated the need for an OSB in 93 (29%) of 318 women. Overall cost savings per 11-g SVAB over OSB were € 242 per case from a hospital perspective, and € 422 per case from a socioeconomic perspective. The use of 11-g SVAB decreased the cost of diagnosis by 7% from a hospital perspective, and by 10% from a socioeconomic perspective.


CONCLUSIONS
In Austria, annual national savings of over 5 million Euro could be realized with the use of 11-g SVAB for the diagnosis of suspicious breast lesions. Although savings per case are modest, the national health care system realizes significant cost reduction as women benefit from a faster and less invasive approach to diagnosis.
Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Vienna, Austria. renate.gruber@meduniwien.ac.at
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Gruber
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Walter
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Helbich
D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D001707:Biopsy, Needle / Q000191:economics* / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000191:economics* / Q000473:pathology*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D013238:Stereotaxic Techniques / Q000191:economics* / Q000706:statistics & numerical data; D055815:Young Adult