Needle core biopsy guided with mammography: a study of cost-effectiveness.

Lindfors, Karen K.; Rosenquist, C. J.

doi:10.1148/radiology.190.1.8259408

Cited by 117 publications

(49 citation statements)

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“…Additionally, the disposable costs of automated needles ($35 for a disposable gun and $25 for a disposable needle [used with a reusable handle that has an initial cost of $1195]; Bard Peripheral Technologies, Covington, GA) used in ultrasonographically guided LCNB are significantly less than the disposable costs related to a directional vacuum-assisted biopsy instrument (as much as $301) and an advanced breast biopsy instrument ($513), which are increasingly used for stereotactic breast biopsy. A cost-effectiveness analysis by Lindfors and Rosenquist 22 has shown that when LCNB is used for the same indications as surgical biopsy, the cost of a breast cancer screening program is substantially reduced. However, LCNB is not a costeffective alternative to short-interval follow-up mammography of probable benign lesions.…”

Section: Discussionmentioning

confidence: 99%

The utility of ultrasonographically guided large‐core needle biopsy: results from 500 consecutive breast biopsies.

Smith

Darling

Meyer

et al. 2001

J of Ultrasound Medicine

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Five hundred ultrasonographically guided large-core needle breast biopsies of solid masses were performed in 446 women. Histopathologic results were correlated with imaging findings. Ultrasonographically guided large-core needle biopsy resulted in diagnosis of malignancy (n = 124) or severe atypical ductal hyperplasia (n = 4) in 128 lesions (26%). In the remaining 372 lesions (74%), ultrasonographically guided large-core needle biopsy yielded benign pathologic results. Follow-up of more than 1 year (n = 225), results of surgical excision (n = 50), or both were obtainable in 275 (74%) of the benign lesions. No malignancies were discovered at surgical excision or during follow-up of this group of benign lesions. There were no complications related to large-core needle biopsy that required additional treatment. Ultrasonographically guided large-core needle biopsy is a safe and accurate method for evaluating breast lesions that require tissue sampling.

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Section: Discussionmentioning

confidence: 99%

The utility of ultrasonographically guided large‐core needle biopsy: results from 500 consecutive breast biopsies.

Smith

Darling

Meyer

et al. 2001

J of Ultrasound Medicine

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“…Recentreportshaveshown that this approachis not cost-effective [10]; if core biopsy is used in lieu of surveillance, the cost-effectivenessof a mammographic screen ing program could decrease by 31%. Brenner andSickles [11] haveshownthatthe ratio of the cost of core biopsy to the cost of mammo graphic surveillance is 8: 1.…”

Section: Discussionmentioning

confidence: 99%

Short-interval follow-up mammography versus immediate core biopsy of benign breast lesions: assessment of patient stress.

Lindfors¹,

O'Connor²,

Acredolo³

et al. 1998

American Journal of Roentgenology

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OBJECTIVE. Thestress experienced bywomen undergoing surveillance mammographyfor benign lesions was compared with that experienced by women undergoing core biopsy of benign lesions. MATERIALSANDMETHODS.Aretrospective survey wasmailed towomen inwhomwere diagnosed breast abnormalities that were likely to be benign and that were stable at short-interval follow-up mammography (n = 174) or in whom a core biopsy of the breast was performed, with benign findings (n = 116). The survey included questions about stress related to the diagnostic experience as well as questions about who advised the women of the results of their breast imaging studies and about the information provided. RESULTS. Eighty eligible surveys werereceived fromthewomen whounderwent shortinterval follow-up mammography, and 58 surveys were received from the women who under went biopsies. The self-reported overall stress experienced by the women who underwent core biopsies was significantly greater (p < .001) than that reported by the group who were fol lowed up with mammography. The level of anxiety was not affected by the patient's percep tion of the probability that the lesion represented carcinoma. We found no significant differences in stress between women who discussed their mammogram results with a radiolo gistandwomenwho were notifiedby theirprimarycareprovider. CONCLUSION. Short-interval follow-up mammography continues tobeacceptable for theevaluationof lesionsthatareprobablybenign,evenwhen patientanxietyis considered.T he widespread use of screening mammography has resulted in the detectionof clinically occult and probably benign lesions in up to 11% of pa tients [ fl. Periodic mammographic surveil lance has been shown to be effective in the management of such abnormalities [1, 2]; however, the increasing availability of breast core biopsy has created controversy about the appropriate role of such biopsies in the evalua tion of these probably benign lesions. Series from the surgical literature have shown posi tive predictive values as low as 8% for core bi opsy [3,4]; authors of these studies have advocated the use of core biopsy instead of surveillance mammography.The suggestion has been made that needle biopsy should be used in lieu of periodic mammography to allay patient anxiety [5,6].Presumably, a definitive and timely diagnosis would entail less stress for the patient than would the uncertainty attending an extended period of surveillance.Becauseno previous empiric studies have focused on the relative stress experienced by women undergoing pe riodic mammographicsurveillanceas com pared with those undergoing immediate core biopsy, we conducted a retrospective, mailed survey to investigate this issue. Materials and MethodsA search of mammography reports from January I, 1994I, , until October 1, 1996, at two institutions yielded 174 women in whom had been diagnosed abnormalities that were probably benign (category lesions under the Breast Imaging Reporting andData System of the AmericanCollege of Radiology [7]) and that were stable at shor...

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“…The cost of additional studies or biopsy in these probably benign lesions can be substantial (28,(49)(50)(51). Since BI-RADS category 3 lesions have a low malignancy rate (0.8%; 95% CI: 0.3%, 1.7%) (six of 745 lesions) and since only one (0.1%) lesion had suspicious changes at short-interval follow-up and one (0.1%) lesion had suspicious…”

Section: Breast Imaging: Probably Benign Lesions At Screening Breast mentioning

confidence: 99%

Probably Benign Lesions at Screening Breast US in a Population with Elevated Risk: Prevalence and Rate of Malignancy in the ACRIN 6666 Trial

Barr¹,

Zhang²,

Cormack³

et al. 2013

Radiology

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Purpose:To prospectively validate predefined breast ultrasonographic (US) Breast Imaging Reporting and Data System (BI-RADS) category 3 criteria in a multicenter setting in an elevated-risk population. Materials andMethods:The American College of Radiology Imaging Network 6666 database was reviewed for prospectively defined BI-RADS category 3 lesions. Patient characteristics, lesion US features at initial detection, and work-up recommendations were analyzed with descriptive statistics. Exact 95% confidence intervals (CIs) were given, where appropriate. Lesion reference standard was biopsy or a minimum of 1-year follow-up. In addition, malignancy rate for lesions that had at least 2 years of follow-up data or that had biopsy data was calculated. Results:Of 2662 : 0.3%, 1.7%) occurred in five (1.0%) of 519 participants: Five malignancies were invasive (median size, 10 mm; size range, 2-18 mm), and one was node positive. When the analysis is limited to lesions with at least 2-year follow-up or biopsy, the malignancy rate among BI-RADS category 3 lesions is 0.9% (95% CI: 0.3%, 2.0%). Three malignant BI-RADS category 3 lesions were sampled for biopsy because of a suspicious change at follow-up (two N0 lesions, one each at 6-and 12-month follow-up; one N1 lesion at 24-month follow-up), one was sampled for biopsy because of an upgrade after additional mammography (NX), one was found at mastectomy for another cancer (N0), and one was found at prophylactic contralateral mastectomy in the same patient (NX). Conclusion:As BI-RADS category 3 lesions have a low malignancy rate (0.8%; 95% CI: 0.3%, 1.7%) and only 0.1% of the cancers had suspicious changes at 6-month follow-up and only one (17%; 95% CI: 0.4%, 64%) of six malignancies were node positive at detection (24-month follow-up), a recommendation of 1-year diagnostic follow-up may be appropriate for BI-RADS category 3 lesions detected at screening US.q RSNA, 2013 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Needle core biopsy guided with mammography: a study of cost-effectiveness.

Cited by 117 publications

References 0 publications

The utility of ultrasonographically guided large‐core needle biopsy: results from 500 consecutive breast biopsies.

The utility of ultrasonographically guided large‐core needle biopsy: results from 500 consecutive breast biopsies.

Short-interval follow-up mammography versus immediate core biopsy of benign breast lesions: assessment of patient stress.

Probably Benign Lesions at Screening Breast US in a Population with Elevated Risk: Prevalence and Rate of Malignancy in the ACRIN 6666 Trial

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