Sonographically guided 11-G directional vacuum-assisted breast biopsy as an alternative to surgical excision: utility and cost study in probably benign lesions

Abstract

Purpose: To evaluate the utility and economic costs of the 11-G vacuum-assisted biopsy probe under ultrasound (US) guidance as an alternative to surgical excision in patients with probably benign lesions.

Material and methods: US-guided 11-G vacuum-assisted biopsy was performed in 102 probably benign breast lesions in 97 women who refused radiological follow-up. Complete removal of the lesion was intended in all cases. Open biopsy was done if questionable pathologic findings were present. Treatment was indicated if the diagnosis was malignant. Economic costs were estimated taking into consideration monetary expenses generated to the public health system, as well as expenses for the patients receiving percutaneous and open surgical biopsy.

Results: Median patient age was 42 years (range 18-77). Median lesion size was 14.7 mm (range 6-30 mm). Complete removal of the lesion seen at imaging was achieved in 72.5% of cases. Adequate tissue samples for histopathological evaluation were obtained in all cases. Surgical biopsy was recommended in nine cases. One patient diagnosed with mucinous carcinoma underwent immediate surgical treatment. The remaining 87 women with 92 lesions were included in a follow-up program. Economic cost of the 11-G vacuum-assisted percutaneous biopsy was 82% lower than the surgical biopsy (total savings in this series: 136,402.84 euros). Time spent for the patient was 71% less in percutaneous biopsy than in surgery.

Conclusion: Ultrasound-guided 11-G directional vacuum-assisted breast biopsy is an accurate and less expensive procedure that can be used as an alternative to open surgical excision in a selected group of patients.