A comparison of Medicare reimbursement and results for various imaging-guided breast biopsy techniques

American Journal of Surgery
R L HowiseyA Morgan

Abstract

The Medicare population makes up a large proportion of the patients who undergo evaluation and treatment of mammographically detected breast lesions. In the past, the standard approach for obtaining a histological specimen for definitive diagnosis has been wire localization followed by open surgical excision (WL-OSE). In recent years, however, imaging-guided large core needle biopsy (LCNB) has been investigated as a more cost effective and less invasive alternative. The authors examined accuracy and reimbursement of ultrasound-guided LCNB, stereotactic-guided LCNB, and WL-OSE in 139 Medicare patients who demonstrated abnormalities on screening mammograms in 1994 and 1995. Ultrasound-guided LCNB was used to diagnose 20% of these cases, sterotactic LCNB was used to diagnose 68% of the cases, and the remaining 12% were diagnosed using WL-OSE. Histological diagnoses for 54 LCNBs (20 ultrasound-guided and 34 stereotactic-guided) were 98% accurate when compared with a subsequent surgical excision specimen. Ultrasound-guided LCNB was the most cost-effective approach, showing an average savings of $1,960 per procedure over WL-OSE and $211 over stereotactic-guided LCNB. Stereotactic-guided LCNB was significantly more cost effective than...Continue Reading

References

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Citations

Oct 13, 2000·Breast Cancer : the Journal of the Japanese Breast Cancer Society·S Y ChanR Carpenter
Feb 13, 2002·American Journal of Surgery·L F SmithV S Klimberg
Aug 31, 2001·Ultrasound in Medicine & Biology·W L SmithA Fenster
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Mar 19, 1999·Annals of Surgical Oncology·V S Klimberg

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