MAMMOGRAPHICALLY DETECTED BREAST-CANCER - BENEFITS OF STEREOTAXIC CORE VERSUS WIRE LOCALIZATION BIOPSY

Objective The authors evaluated the differences between stereotactic c ore needle biopsy (SCNBx) and needle localization surgical biopsy (NLB x) in cost and treatment course for patients with mammographically det ected breast cancer. Summary Background Data Stereotactic core needle breast biopsy is a reproducible and reliable alternative to surgical b iopsy for histologic diagnosis of mammographic lesions. Methods Record s from 52 consecutive patients with invasive breast cancer diagnosed b y SCNBx (n = 21) or NLBx (n = 31)over 2 years were reviewed. Episode-o f-care costs were extracted from the Barnes Hospital billing system da tabase. Results At the time of excision, surgical margins were statist ically more frequently positive in patients treated with NLBx (55%) th an patients treated with SCNBx (0%, p < 0.0001). Furthermore, patients in the NLBx group undergoing breast conservation surgery required re- excision more frequently (74%) than those in the SCNBx group (0%, p = 0.001). There were no complications in either group after the diagnost ic procedure. All SCNBx results were correct in the diagnosis of invas ive breast cancer. The median cost of SCNBx was approximately $1000 le ss than the median cost of NLBx. This cost difference was carried thro ugh the definitive procedure, whether it was breast conservation or ma stectomy. Conclusions This study shows the advantage of SCNBx to diagn ose breast cancer and definitive operative care al a single procedure. The preoperative diagnosis of breast cancer eliminated positive opera tive margins and procedures to re-excise breast tissue. The use of SCN Bx also saved approximately $1000 per patient compared with the use of NLBx. Our data suggest that SCNBx is the diagnostic procedure of choi ce for mammographically detected cancers.