TY - JOUR
T1 - Stereotactic core biopsy reduces the reexcision rate and the cost of mammographically detected cancer
AU - Lind, D. Scott
AU - Minter, Rebecca
AU - Steinbach, Barbara
AU - Abbitt, Patricia
AU - Lanier, Linda
AU - Haigh, Linda
AU - Vauthey, J. Nicholas
AU - Russin, Millie
AU - Hackett, Raymond
AU - Copeland, Edward M.
PY - 1998/7/15
Y1 - 1998/7/15
N2 - The management of patients with mammographic abnormalities is rapidly shifting from needle-localized surgical biopsy (NLB) to stereotactic core biopsy (SCB). The precise role of SCB in the management of nonpalpable breast cancer remains to be defined. The purpose of this study was to compare SCB to NLB in the diagnosis of mammographically detected breast cancer in women who underwent breast-conserving surgery. The records of all patients with nonpalpable breast cancer who underwent breast-conserving surgery from 1/1/95 to 6/1/97 were analyzed with respect to method of diagnosis, time interval from detection to diagnosis and breast-conserving surgery, volume of breast tissue excised, margin status and reexcision rate, number of surgical procedures, and total charges and costs per patient. During a 30-month period, 117 patients with nonpalpable breast cancer underwent breast- conserving surgery. The diagnosis was made by NLB in 69 patients and SCB in 48 patients. The time from detection to diagnosis and breast-conserving surgery was 1.7 ± 0.5 and 8.1 ± 1.2 days for SCB patients and 6.8 ± 1.3 and 16.9 ± 2.3 days for NLB patients (P 0.01). The volume of breast tissue removed was 117.9 ± 5.6 cm3 for SCB patients versus 75.2 ± 2.9 cm3 for NLB patients (P < 0.01). Three SCB patients (6%) had positive margins, while 38 NLB patients (55%) had positive margins (P < 0.01). Only 1 SCB patient (2%) was reexcised, while 34 NLB patients (50%) were reexcised (P 0.01). Eighty-nine percent of SCB patients had a single surgical procedure compared to 39% of NLB patients (P < 0.001). Patients who underwent SCB had reduced total charges and total costs per patient compared to NLB patients ($11,700 ± $554 and $3537 ± $167 per SCB patient versus $15,654 ± $706 and $4853 ± $198 per NLB patient, P < 0.0001). Stereotactic core biopsy shortens the time from detection at mammography to diagnosis and breast-conserving therapy, permits appropriate discussion of treatment alternatives, reduces the positive margin rate and reexcision rate, and may represent a significant cost savings in the management of nonpalpable breast cancer.
AB - The management of patients with mammographic abnormalities is rapidly shifting from needle-localized surgical biopsy (NLB) to stereotactic core biopsy (SCB). The precise role of SCB in the management of nonpalpable breast cancer remains to be defined. The purpose of this study was to compare SCB to NLB in the diagnosis of mammographically detected breast cancer in women who underwent breast-conserving surgery. The records of all patients with nonpalpable breast cancer who underwent breast-conserving surgery from 1/1/95 to 6/1/97 were analyzed with respect to method of diagnosis, time interval from detection to diagnosis and breast-conserving surgery, volume of breast tissue excised, margin status and reexcision rate, number of surgical procedures, and total charges and costs per patient. During a 30-month period, 117 patients with nonpalpable breast cancer underwent breast- conserving surgery. The diagnosis was made by NLB in 69 patients and SCB in 48 patients. The time from detection to diagnosis and breast-conserving surgery was 1.7 ± 0.5 and 8.1 ± 1.2 days for SCB patients and 6.8 ± 1.3 and 16.9 ± 2.3 days for NLB patients (P 0.01). The volume of breast tissue removed was 117.9 ± 5.6 cm3 for SCB patients versus 75.2 ± 2.9 cm3 for NLB patients (P < 0.01). Three SCB patients (6%) had positive margins, while 38 NLB patients (55%) had positive margins (P < 0.01). Only 1 SCB patient (2%) was reexcised, while 34 NLB patients (50%) were reexcised (P 0.01). Eighty-nine percent of SCB patients had a single surgical procedure compared to 39% of NLB patients (P < 0.001). Patients who underwent SCB had reduced total charges and total costs per patient compared to NLB patients ($11,700 ± $554 and $3537 ± $167 per SCB patient versus $15,654 ± $706 and $4853 ± $198 per NLB patient, P < 0.0001). Stereotactic core biopsy shortens the time from detection at mammography to diagnosis and breast-conserving therapy, permits appropriate discussion of treatment alternatives, reduces the positive margin rate and reexcision rate, and may represent a significant cost savings in the management of nonpalpable breast cancer.
KW - Breast cancer
KW - Cost
KW - Reexcision
KW - Stereotactic biopsy
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U2 - 10.1006/jsre.1998.5380
DO - 10.1006/jsre.1998.5380
M3 - Article
C2 - 9733612
AN - SCOPUS:0032527409
SN - 0022-4804
VL - 78
SP - 23
EP - 26
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 1
ER -