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Accuracy and Cost of Needle Localization Breast Biopsy

Accuracy and Cost of Needle Localization Breast Biopsy Abstract • The success and cost of needle localization biopsy (NLB) performed with local anesthesia in an outpatient procedure room (81 biopsies, group 1) or under general anesthesia in an operating room (36 biopsies, group 2) were compared in a longitudinal study. Only 78% of operations in group 1 successfully removed the target breast lesion; definite failure occurred in 17%, and results were indeterminate in 5%. Among lesions sought by group 2 procedures, 92% of lesions were removed successfully, 5% were missed, and 3% were indeterminate. The incidence of carcinoma in breast specimens was 17% in group 1 and 22% in group 2. Wound infection occurred after 6% of group 1 biopsies. The total cost of NLB was $775 in group 1 and $1960 in group 2. The difference in cost represented by the use of general anesthesia was $1260. The added expense of NLB done in an operating room under general anesthesia can be justified by a high rate of success in removing the breast lesion, by patient comfort, and by technical ease. (Arch Surg 1988;123:947-950) References 1. Proudfoot RW, Mattingly SS, Stelling CB, et al: Nonpalpable breast lesions: Wire localization and excisional biopsy . Am Surg 1986;52:117-122. 2. Marrujo G, Jolly PC, Hall MH: Nonpalpable breast cancer: Needle-localized biopsy for diagnosis and considerations for treatment . Am J Surg 1986;151:599-602.Crossref 3. Bigelow R, Smith R, Goodman PA, et al: Needle localization of nonpalpable breast masses . Arch Surg 1985;120:565-569.Crossref 4. Tinnemans JG, Wobbes T, Lubbers EJ, et al: The significance of microcalcifications without palpable mass in the diagnosis of breast cancer . Surgery 1986;99:652-657. 5. Tinnemans JG, Wobbes T, Hendriks JH, et al: Localization and excision of nonpalpable breast lesions . Arch Surg 1987;122:802-806.Crossref 6. Landercasper J, Gundersen SB, Gundersen AL, et al: Needle localization and biopsy of nonpalpable lesions of the breast . Surg Gynecol Obstet 1987;164:399-403. 7. Solmer R, Goodstein J, Agliozzo C: Nonpalpable breast lesions discovered by mammography . Arch Surg 1980;115:1067-1069.Crossref 8. Chetty U, Kirkpatrick AE, Anderson TL, et al: Localization and excision of occult breast lesions . Br J Surg 1983;70:607-609.Crossref 9. Hall WC, Aust JB, Gaskill HV, et al: Evaluation of nonpalpable breast lesions . Am J Surg 1986;151:467-469.Crossref 10. Homer MJ, Smith TJ, Marehart DJ: Outpatient needle localization and biopsy for nonpalpable breast lesions . JAMA 1984;252:2452-2454.Crossref 11. Schwartz GF, Feig SA, Rosenberg AL, et al: Localization and significance of clinically occult breast lesions: Experience with 469 needle-guided biopsies . Recent Results Cancer Res 1984;90:125-132. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Accuracy and Cost of Needle Localization Breast Biopsy

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1988.01400320033005
Publisher site
See Article on Publisher Site

Abstract

Abstract • The success and cost of needle localization biopsy (NLB) performed with local anesthesia in an outpatient procedure room (81 biopsies, group 1) or under general anesthesia in an operating room (36 biopsies, group 2) were compared in a longitudinal study. Only 78% of operations in group 1 successfully removed the target breast lesion; definite failure occurred in 17%, and results were indeterminate in 5%. Among lesions sought by group 2 procedures, 92% of lesions were removed successfully, 5% were missed, and 3% were indeterminate. The incidence of carcinoma in breast specimens was 17% in group 1 and 22% in group 2. Wound infection occurred after 6% of group 1 biopsies. The total cost of NLB was $775 in group 1 and $1960 in group 2. The difference in cost represented by the use of general anesthesia was $1260. The added expense of NLB done in an operating room under general anesthesia can be justified by a high rate of success in removing the breast lesion, by patient comfort, and by technical ease. (Arch Surg 1988;123:947-950) References 1. Proudfoot RW, Mattingly SS, Stelling CB, et al: Nonpalpable breast lesions: Wire localization and excisional biopsy . Am Surg 1986;52:117-122. 2. Marrujo G, Jolly PC, Hall MH: Nonpalpable breast cancer: Needle-localized biopsy for diagnosis and considerations for treatment . Am J Surg 1986;151:599-602.Crossref 3. Bigelow R, Smith R, Goodman PA, et al: Needle localization of nonpalpable breast masses . Arch Surg 1985;120:565-569.Crossref 4. Tinnemans JG, Wobbes T, Lubbers EJ, et al: The significance of microcalcifications without palpable mass in the diagnosis of breast cancer . Surgery 1986;99:652-657. 5. Tinnemans JG, Wobbes T, Hendriks JH, et al: Localization and excision of nonpalpable breast lesions . Arch Surg 1987;122:802-806.Crossref 6. Landercasper J, Gundersen SB, Gundersen AL, et al: Needle localization and biopsy of nonpalpable lesions of the breast . Surg Gynecol Obstet 1987;164:399-403. 7. Solmer R, Goodstein J, Agliozzo C: Nonpalpable breast lesions discovered by mammography . Arch Surg 1980;115:1067-1069.Crossref 8. Chetty U, Kirkpatrick AE, Anderson TL, et al: Localization and excision of occult breast lesions . Br J Surg 1983;70:607-609.Crossref 9. Hall WC, Aust JB, Gaskill HV, et al: Evaluation of nonpalpable breast lesions . Am J Surg 1986;151:467-469.Crossref 10. Homer MJ, Smith TJ, Marehart DJ: Outpatient needle localization and biopsy for nonpalpable breast lesions . JAMA 1984;252:2452-2454.Crossref 11. Schwartz GF, Feig SA, Rosenberg AL, et al: Localization and significance of clinically occult breast lesions: Experience with 469 needle-guided biopsies . Recent Results Cancer Res 1984;90:125-132.

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1988

References