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Multicenter Study
. 2004 Jan 26;90(2):383-92.
doi: 10.1038/sj.bjc.6601520.

Cost-effectiveness of stereotactic large-core needle biopsy for nonpalpable breast lesions compared to open-breast biopsy

J H Groenewoud  1 , R M Pijnappel, M E van den Akker-Van Marle, E Birnie, T Buijs-van der Woude, W P Th M Mali, H J de Koning, E Buskens
Affiliations
Multicenter Study

Cost-effectiveness of stereotactic large-core needle biopsy for nonpalpable breast lesions compared to open-breast biopsy

J H Groenewoud et al. Br J Cancer. .

Abstract

This paper demonstrates that the introduction of large-core needle biopsy (LCNB) replacing needle-localised breast biopsy (NLBB) for nonpalpable (screen-detected) breast lesions could result in substantial cost savings at the expense of a possible slight increase in breast cancer mortality. The cost-effectiveness of LCNB and NLBB was estimated using a microsimulation model. The sensitivity of LCNB (0.97) and resource use and costs of LCNB and NLBB were derived from a multicentre consecutive cohort study among 973 women who consented in getting LCNB and NLBB, if LCNB was negative. Sensitivity analyses were performed. Replacing NLBB with LCNB would result in approximately six more breast cancer deaths per year (in a target population of 2.1 million women), or in 1000 extra life-years lost from breast cancer (effect over 100 years). The total costs of management of breast cancer (3% discounted) are estimated at pound 4676 million with NLBB; introducing LCNB would save pound 13 million. The incremental cost-effectiveness ratio of continued NLBB vs LCNB would be pound 12 482 per additional life-year gained (3% discounted); incremental costs range from pound -21 687 (low threshold for breast biopsy) to pound 74 378 (high sensitivity of LCNB).

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Figures

Figure 1
Figure 1
Diagnostic procedures for nonpalpable breast lesions detected at screening (model input). Needle-localised breast biopsy (scenario (B)) and LCNB (scenario (C)), FNA=fine needle aspiration (cytology), malign: invasive breast carcinoma or ductal carcinoma in situ, nonconclusive: normal tissue or high-risk lesion.
Figure 1
Figure 1
Diagnostic procedures for nonpalpable breast lesions detected at screening (model input). Needle-localised breast biopsy (scenario (B)) and LCNB (scenario (C)), FNA=fine needle aspiration (cytology), malign: invasive breast carcinoma or ductal carcinoma in situ, nonconclusive: normal tissue or high-risk lesion.
Figure A1
Figure A1
Structure of the MISCAN model for breast cancer.
See this image and copyright information in PMC

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References

    1. BreastScreen Victoria (2000) BreastScreen Victoria 1998 Highlights
    1. Boer R, de Koning H, Threlfall A, Warmerdam P, Street A, Friedman E, Woodman C (1998) Cost effectiveness of shortening screening interval or extending age range of NHS breast screening programme: computer simulation study. Br Med J 317: 376–379 - PMC - PubMed
    1. Boer R, de Koning HJ, van Oortmarssen GJ, van der Maas PJ (1995) In search of the best upper age limit for breast cancer screening. Eur J Cancer 31A: 2040–2043 - PubMed
    1. Britton PD, Flower CD, Freeman AH, Sinnatamby R, Warren R, Goddard MJ, Wight DG, Bobrow L (1997) Changing to core biopsy in an NHS breast screening unit. Clin Radiol 52: 764–767 - PubMed
    1. Buijs-van der Woude T, Verkooijen HM, Pijnappel RM, Klinkenbijl JHG, Borel Rinkes IHM, Peeters PHM, Buskens E (2001) Cost comparison between stereotactic large-core-needle biopsy versus surgical excision biopsy in The Netherlands. Eur J Cancer 37: 1736–1745 - PubMed

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