Liberman L, Fahs M C, Dershaw D D, Bonaccio E, Abramson A F, Cohen M A, Hann L E
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Radiology. 1995 Jun;195(3):633-7. doi: 10.1148/radiology.195.3.7753986.
To determine the frequency with which stereotaxic core biopsy of the breast obviated diagnostic surgical biopsy and to estimate the savings in cost of diagnosis with this procedure.
Stereotaxic core biopsy of 182 nonpalpable, mammographically evident lesions was performed, and data from clinical follow-up were obtained. Savings in cost were assessed by using national Medicare reimbursement data and a relative value system based on national physician reviews (Relative Values for Physicians [RVP]).
Stereotaxic core biopsy replaced a surgical procedure in 140 of 182 patients. The mean adjusted direct savings in cost per stereotaxic core biopsy were $893 (Medicare) or $1,491 (RVP). Use of stereotaxic core biopsy decreased the cost of diagnosis by 52% (RVP) or 55% (Medicare).
Stereotaxic core biopsy obviated surgical biopsy for most nonpalpable lesions sampled, resulting in a greater than 50% reduction in biopsy costs. If these results were generalizable to the national level, annual savings would approach $200 million.
确定乳腺立体定向核心活检避免诊断性手术活检的频率，并评估该程序在诊断成本方面的节省情况。
对182个乳腺X线摄影显示的不可触及病变进行了立体定向核心活检，并获得了临床随访数据。通过使用国家医疗保险报销数据和基于全国医生评估的相对价值系统（医生相对价值[RVP]）来评估成本节省情况。
182例患者中有140例通过立体定向核心活检取代了手术程序。每次立体定向核心活检平均调整后的直接成本节省为893美元（医疗保险）或1491美元（RVP）。使用立体定向核心活检使诊断成本降低了52%（RVP）或55%（医疗保险）。
立体定向核心活检避免了对大多数所取的不可触及病变进行手术活检，活检成本降低了50%以上。如果这些结果能推广到全国范围，每年节省的费用将接近2亿美元。
