Total cost comparison of 2 biopsy methods for nonpalpable breast lesions

Objective: To identify, quantify, and compare total facility costs for 2 br east biopsy methods: vacuum-assisted biopsy (VAB) and needle-wire-localized open surgical biopsy (OSB). Study Design: A time-and-motion study was done to identify unit resources u sed in both procedures. Costs were imputed from published literature to val ue resources. A com parison of the total (fixed and variable) costs of the 2 procedures was done. Patients and Method: A convenience sample of 2 high-volume breast biopsy (b oth VAB and OSB) facilities was identified. A third facility (OSB only) and 8 other sites (VAB only) were used to capture variation. Staff interviews, patient medical records, and billing data were used to check observed data . One hundred and sixty-seven uncomplicated procedures (71 OSBs, 96 VABs) w ere observed. Available demographic and clinical data were analyzed to asse ss selection bias, and sensitivity analyses were done on the main assumptio ns. Results: The total facility costs of the VAB procedure were lower than the costs of the OSB procedure. The overall cost advantage for using VAB ranges from $314 to $843 per procedure depending on the facility type. Variable c ost comparison indicated little difference between the 2 procedures. The la rgest fixed cost difference was $763. Conclusions: Facilities must consider the cost of new technology, especiall y when the new technology is as effective as the present technology. The se emingly high cost of equipment might negatively influence a decision to ado pt VAB, but when total facility costs were analyzed, the new technology was less costly.