Accuracy and cost of needle localization breast biopsy
L. W. Norton, B. E. Zeligman and N. W. Pearlman
Department of Surgery, University of Colorado School of Medicine, Denver 80262.
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.