STEREOTAXIC BREAST BIOPSY AS AN ALTERNATIVE TO OPEN EXCISIONAL BIOPSY

Background: Health care cost continues to play a dominant role in our society. Technological advances are expensive, with the possible excep tion of stereotactic breast biopsy. We must learn other alternatives t hat give the same diagnostic accuracy at lower cost. The intention of this study was to find other acceptable alternatives to open excisiona l breast biopsies. Methods: Patients were referred to Baylor Universit y Medical Center between May 1990 and June 1992 for stereotactic breas t biopsy of nonpalpable mammographic abnormalities. Before stereotacti c biopsy, lesions were categorized into low or high suspicion for mali gnancy based on screening mammography. Slides were reviewed by a patho logist and the histological diagnosis was compared with mammographic c haracterization. Benign histology confirming the low-suspicion mammogr aphic abnormality demonstrated mammographic and histologic correlation . Mammographic follow-up was recommended. Results: Two hundred twenty- five women underwent 250 stereotactic breast biopsies. Malignancy was diagnosed in 47 patients; the remaining 203 lesions were benign on pat hological examination and are being followed regularly. Seventy-eight percent of the lesions were characterized as low suspicion for maligna ncy, ind 22% were characterized as high suspicion. The average cost sa vings per lesion using stereotactic biopsy was $1,629. Conclusion: Ste reotactic breast biopsy is an acceptable, less expensive alternative t o open excisional biopsy for diagnosing nonpalpable mammographic findi ngs.