Dl. Rimm et al., COMPARISON OF THE COSTS OF FINE-NEEDLE ASPIRATION AND OPEN SURGICAL BIOPSY AS METHODS FOR OBTAINING A PATHOLOGICAL DIAGNOSIS, Cancer cytopathology, 81(1), 1997, pp. 51-56
BACKGROUND. A pathologic diagnosis is usually required to determine de
finitive management for a palpable lesion. In this era of cost control
, fine-needle aspiration (FNA) provides a low-cost alternative to open
excisional biopsy. Using a broad range of cases collected over 20 yea
rs, the authors of this study sought to quantify the savings resulting
from the use of FNA on superficial palpable lesions to obtain a patho
logic diagnosis. METHODS, 12,452 cases collected by the cytopathology
service at the Medical College of Virginia during the period 1972-1991
were used to produce a profile of case type, diagnosis, and indicatio
n for surgery. Charge-based cost estimations or Relative Value Units w
ere calculated using the 1995 Physicians' Fee Reference or published M
edicare participant fees. The charges for the FNA procedure and open s
urgical biopsy were compared, and all other biopsy-related costs were
omitted. RESULTS, FNA provided a sufficient pathologic diagnosis to ob
viate open surgical biopsy in 63-85% of the cases. Estimation of cost
savings on the basis of the distribution of cases and indications for
surgery suggested a savings of $250,000 to $750,000 per 1000 FNA perfo
rmed, or approximately 5500 Relative Value Units. CONCLUSIONS. This st
udy quantifies the substantial savings that result from obtaining a pa
thologic diagnosis by the FNA procedure rather than open surgical biop
sy. (C) 1997 American Cancer Society.