Abstract
Health care reform goals involve more cost-effective methods of delivering health care. The cost-effectiveness of axillary ultrasound-guided core needle biopsy (AUS-CNB) was compared with sentinel lymph node biopsy (SLNB) when evaluating the status of the axilla in operable invasive breast cancer. We performed an IRB-approved retrospective review of patients undergoing ultrasound of the axilla plus core needle biopsy at our institution from 2007 to 2012. An accuracy of technique and cost analysis (TreeAge Pro 2009) of AUS-CNB vs SLNB was conducted. The cohort of 95 patients was divided into 2 groups: clinically positive (CP) (32%) and negative (CN) (68%) axilla. In the CP group, 83% had a suspicious AUS, of which 90% were positive. In the CN group, AUS was suspicious in 70%, with a positive biopsy in 59%. The sensitivity and specificity of AUS-CNB were 90% (95% CI 84.8% to 98.8%) and 100% (95% CI 27% to 59.1%), respectively. Cost estimates comparing AUS-CNB with SLNB demonstrated a cost saving of $236,517 in the CP axilla and $248,490 in the CN axilla, for a total cost savings of $485,007. Axillary ultrasound-guided core needle biopsy is a sensitive, diagnostic, surgeon-performed procedure. It is time-saving, cost-efficient, an...Continue Reading
References
Oct 1, 1998·The New England Journal of Medicine·D KragP Beitsch
Nov 1, 2002·Radiology·Sven C A MichelRahel A Kubik-Huch
May 9, 2003·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·E E DeurlooL J Schultze Kool
Apr 23, 2004·European Journal of Nuclear Medicine and Molecular Imaging·Giuseppe TrifiròGiovanni Paganelli
May 11, 2004·European Journal of Nuclear Medicine and Molecular Imaging·Flavio CrippaEmilio Bombardieri
Dec 24, 2005·Annals of Surgical Oncology·Maartje C van RijkBin B R Kroon
Apr 25, 2006·AJR. American Journal of Roentgenology·Soledad AlvarezJulia Cortés
Jun 11, 2008·BMC Cancer·Shigeto UedaHidetaka Mochizuki
Oct 29, 2008·Radiology·Hiroyuki AbeGillian M Newstead
May 6, 2009·European Journal of Nuclear Medicine and Molecular Imaging·Till A HeusnerAlexander Stahl
Apr 13, 2010·Clinical Radiology·P BrittonM Wallis
Oct 23, 2010·AJR. American Journal of Roentgenology·Martha B MainieroMaureen A Chung
Dec 1, 2010·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Y MengL Wyld
Feb 1, 2011·Health Technology Assessment : HTA·K L CooperE Lorenz
May 25, 2011·Annals of Surgical Oncology·Kazuyoshi MotomuraKatsuyuki Nakanishi
Sep 16, 2011·Annals of Surgery·Chad B JohnsonV Suzanne Klimberg
Nov 15, 2011·Journal of the American College of Surgeons·Jacqueline G SolonArnold D K Hill
May 21, 2013·The Lancet Oncology·Thorsten KuehnMichael Untch
Oct 9, 2013·JAMA : the Journal of the American Medical Association·Judy C BougheyUNKNOWN Alliance for Clinical Trials in Oncology
Citations
Sep 28, 2016·Journal of Vascular and Interventional Radiology : JVIR·Mehran Midia, Dyda Dao
Oct 12, 2016·The Breast : Official Journal of the European Society of Mastology·Marco GipponiDaniele Friedman
Sep 7, 2018·Irish Journal of Medical Science·Michael R BolandBrigid A Merrigan
Nov 19, 2015·Annals of Surgical Oncology·V Suzanne Klimberg
Jul 12, 2020·Breast Cancer Research and Treatment·Aubriana M McEvoyWilliam E Gillanders
May 8, 2021·International Journal of Clinical Practice·İsmail ÖzlerCihangir Özaslan
May 28, 2021·Breast Cancer : Targets and Therapy·Michael Y Chen, William E Gillanders