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Reducing the cost of diagnosis of breast carcinoma: impact of ultrasound and imaging-guided biopsies on a clinical breast practice.
Rubin, E; Mennemeyer, S T; Desmond, R A; Urist, M M; Waterbor, J; Heslin, M J; Bernreuter, W K; Dempsey, P J; Pile, N S; Rodgers, W H.
Afiliación
  • Rubin E; Department of Radiology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35294, USA. erubin@uabmc.edu
Cancer ; 91(2): 324-32, 2001 Jan 15.
Article en En | MEDLINE | ID: mdl-11180078
ABSTRACT

BACKGROUND:

The objective of this study was to determine whether the use of ultrasound and percutaneous breast biopsies in patients with screen-detected nonpalpable abnormalities can reduce benign open surgical biopsies of the breast without increasing cost or sacrificing detection of potentially curable breast carcinomas.

METHOD:

Using a computerized mammography database and consecutive logs of needle localization procedures and fine- and large core needle biopsies of a single university-based breast imaging practice, the authors determined the breast carcinoma yield and cost of diagnosis over a 14-year period and the changes that occurred over time with the sequential introduction of ultrasound, ultrasound-guided biopsies, and stereotactic biopsies.

RESULTS:

The overall breast carcinoma yield for needle localization biopsies of nonpalpable lesions increased from 21% in 1984 to 68% in 1998 (P < 0.0001). The yield for nonpalpable masses increased from 21% to 87% (P < 0.0001) over the same period. The selective use of ultrasound alone and percutaneous fine- and large core needle biopsy resulted in a substantial reduction in benign open surgical biopsies. A cost analysis showed a 50% reduction in the average expense of discovering breast carcinoma. The breast carcinomas detected after introduction of these methods were prognostically favorable with 88% measuring 1.5 cm or less in size and 66% measuring less than 1 cm.

CONCLUSIONS:

Selective use of ultrasound and imaging-guided percutaneous biopsies can significantly reduce the number of benign open surgical biopsies generated by mammographic screening. This can result in substantial cost savings without decreasing the sensitivity for detecting small potentially curable lesions.
Asunto(s)
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Base de datos: MEDLINE Asunto principal: Biopsia con Aguja / Neoplasias de la Mama / Ultrasonografía Mamaria Tipo de estudio: Diagnostic_studies / Health_economic_evaluation Idioma: En Revista: Cancer Año: 2001 Tipo del documento: Article
Buscar en Google
Base de datos: MEDLINE Asunto principal: Biopsia con Aguja / Neoplasias de la Mama / Ultrasonografía Mamaria Tipo de estudio: Diagnostic_studies / Health_economic_evaluation Idioma: En Revista: Cancer Año: 2001 Tipo del documento: Article