US-GUIDED CORE BREAST BIOPSY - USE AND COST-EFFECTIVENESS

PURPOSE: to determine the frequency with which ultrasonographically (U S) guided core biopsy obviated diagnostic surgical biopsy of nonpalpab le breast masses, to calculate the cost savings of diagnosis attributa ble to US-guided core biopsy, and to compare the cost of US-guided ver sus stereotactically guided core biopsy. MATERIALS AND METHODS: US-gui ded core biopsy was performed in 151 consecutive solitary, nonpalpable breast masses in 151 women (age range, 23-80 years) by using a 14-gua ge automated gun and needle. Clinical follow-up data were obtained. co st savings were assessed by using national Medicare reimbursement cost s of $385 for US-guided core biopsy, $610 for stereotactic core biopsy , and $1,332 for needle localization and surgical biopsy. RESULTS: US- guided core biopsy obviated a surgical procedure in 128 (85%) of 151 w omen. The mean adjusted direct cost saving per US-guided core biopsy w as $744 per case. Use of US-guided biopsy decreased the cost of diagno sis by 56% ($744,/$1,332) over the cost of surgical biopsy. If biopsy had been performed with stereotactic rather than with US guidance, the mean adjusted direct cost saving would have been $519 per case, a 39% ($519/$1,332) decrease in the cost of diagnosis compared with th cost of surgical biopsy. CONCLUSION: Percutaneous biopsy of a nonpalpable breast mass with either US or stereotactic guidance is less expensive than surgery, but cost savings are greater with US-guided biopsy.