Total cost comparison of 2 biopsy methods for nonpalpable breast lesions.

Objective: To identify, quantify, and compare total facility costs for 2 breast 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 used in both procedures. Costs were imputed from published literature to value resources. A comparison 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 (both 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) were observed. Available demographic and clinical data were analyzed to assess selection bias, and sensitivity analyses were done on the main assumptions.

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 cost comparison indicated little difference between the 2 procedures. The largest fixed cost difference was $763.

Conclusions: Facilities must consider the cost of new technology, especially when the new technology is as effective as the present technology. The seemingly high cost of equipment might negatively influence a decision to adopt VAB, but when total facility costs were analyzed, the new technology was less costly.