Cost-effectiveness of stereotactic 11-gauge directional vacuum-assisted breast biopsy

OBJECTIVE. The purpose of our study was to determine the frequency with which stereotactic Ii-gauge directional vacuum-assisted breast biopsy obviated a surgical procedure and to calculate cost savings attributable to that biopsy method. MATERIALS AND METHODS. We retrospectively reviewed 200 consecutive solitary nonpalpable lesions on which stereotactic ii-gauge directional vacuum-assisted breast biopsy was performed. Cost savings were calculated using Medicare reimbursements. Mammograms, histologic findings, and medical records were reviewed. RESULTS. Stereotactic 11-gauge directional vacuum-assisted biopsy obviated a surgical procedure in 151 (76%) of 200 lesions, including 112 (73%) of 153 calcific lesions and 39 (85%) of 46 masses. Reasons fur not obviating a surgical procedure in 39 lesions (25%) included recommendation for surgical biopsy in 35 lesions (18%;), small carcinomas treated by excision in 10 lesions (5%), and histologic underestimation in four lesions (2%). Stereotactic Ii-gauge directional vacuum-assisted biopsy decreased the cost of diagnosis by $263 per case, a 20% ($261/$1289) decrease in the cost of diagnosis compared with surgical biopsy. Of 200 lesions that had stereotactic 11-gauge directional vacuum-assisted biopsy, 106 (53%) would not have been amenable to 14-gauge automated core biopsy because of their small size, their superficial location, or inadequate breast thickness. CONCLUSION, Stereotactic Ii-gauge directional vacuum-assisted breast biopsy obviated a surgical procedure in 76% of lesions, yielding a 20% decrease in cost of diagnosis compared with surgical biopsy. Although savings per case are modest, Ii-gauge directional vacuum-assisted biopsy expands the spectrum of lesions amenable to stereotactic biopsy, increasing cost savings in the population.