THE PALPABLE BREAST NODULE - A COST-EFFECTIVENESS ANALYSIS OF ALTERNATE DIAGNOSTIC APPROACHES

Background. Traditionally, open biopsy has been considered the optimal procedure for the diagnosis of breast nodules. Fine-needle aspiration biopsy (FNAB) has been proposed as an alternate method for the diagnosis of many palpable breast lesions. Methods. The authors compared the diagnostic utility of open biopsy and FNAB using decision tree and cost-effectiveness analyses. Results. When compared with two-step excisional biopsy, FNAB achieved a savings of over $700 at the cost of 0.1% decrease in 10-year overall survival. Conclusions. These data indicate FNAB to be a reasonable alternative to open biopsy for the diagnosis of palpable breast lesions in many patients.