Impact of stereotaxic core breast biopsy on cost of diagnosis.

PURPOSE: To determine the frequency with which stereotaxic core biopsy of the breast obviated diagnostic surgical biopsy and to estimate the savings in cost of diagnosis with this procedure. MATERIALS AND METHODS: Stereotaxic core biopsy of 182 nonpalpable, mammographically evident lesions was performed, and data from clinical follow-up were obtained. Savings in cost were assessed by using national Medicare reimbursement data and a relative value system based on national physician reviews (Relative Values for Physicians RVP). RESULTS: Stereotaxic core biopsy replaced a surgical procedure in 140 of 182 patients. The mean adjusted direct savings in cost per stereotaxic core biopsy were 893 (Medicare) or 1, 491 (RVP). Use of stereotaxic core biopsy decreased the cost of diagnosis by 52% (RVP) or 55% (Medicare). CONCLUSION: Stereotaxic core biopsy obviated surgical biopsy for most nonpalpable lesions sampled, resulting in a greater than 50% reduction in biopsy costs. If these results were generalizable to the national level, annual savings would approach 200 million.