SELECTIVE USE OF IMAGE-GUIDED LARGE-CORE NEEDLE-BIOPSY OF THE BREAST - ACCURACY AND COST-EFFECTIVENESS

OBJECTIVE. We examined the accuracy and cost-effectiveness of large-co re needle breast biopsy in a selected group of patients with mammograp hically detected lesions. MATERIALS AND METHODS. We selectively used l arge-core needle biopsy to sample breast lesions that were intermediat e (neither clearly benign nor clearly malignant) and wire localization biopsy to sample breast lesions that were strongly suggestive of canc er. We compared 2 years' experience using this protocol with the prece ding 2 years at the University of Utah Health Sciences Center during w hich we did only a few large-core needle biopsies on a nonselective ba sis.RESULTS. Our biopsy rate increased from one biopsy per 36 mammogra phic screening examinations to one per 26 (p = .001) when the protocol was used. The cost of biopsy per cancer detected decreased from $11,5 55 to $8356. The specificity of large-core needle biopsy was 98%; the sensitivity based on limited follow-up was 100%. CONCLUSION. Large-cor e needle biopsy is an accurate and cost-effective method for sampling breast lesions when used in a selective fashion.