Cost comparison between stereotactic large-core-needle biopsy versus surgical excision biopsy in The Netherlands

Buijs-van der Woude, T; Verkooijen, H.M; Pijnappel, R.M; Klinkenbijl, J.H.G; Borel Rinkes, I.H.M; Peeters, P.H.M; Buskens, E; on behalf of the COBRA study group,

Next »European Journal of Cancer
Volume 37, Issue 14 , Pages 1736-1745, September 2001

Cost comparison between stereotactic large-core-needle biopsy versus surgical excision biopsy in The Netherlands

T Buijs-van der Woude
- Julius Center for General Practice and Patient Oriented Research, University Medical Center Utrecht, HP D01.335, PO Box 85500, 3508 GA Utrecht, The Netherlands
H.M Verkooijen
- Department of Surgery, University Medical Center Utrecht, The Netherlands
R.M Pijnappel
- Department of Radiology, Martini Ziekenhuis Groningen, The Netherlands
J.H.G Klinkenbijl
- Department of Surgery, Ziekenhuis Rijnstate, Arnhem, The Netherlands
I.H.M Borel Rinkes
- Department of Surgery, University Medical Center Utrecht, The Netherlands
P.H.M Peeters
- Julius Center for General Practice and Patient Oriented Research, University Medical Center Utrecht, HP D01.335, PO Box 85500, 3508 GA Utrecht, The Netherlands
E Buskens
- Julius Center for General Practice and Patient Oriented Research, University Medical Center Utrecht, HP D01.335, PO Box 85500, 3508 GA Utrecht, The Netherlands
- Corresponding author. Tel.: +31-30-250-9353; fax: +31-30-250-5485
on behalf of the COBRA study group

Received 23 April 2001; accepted 23 May 2001.

Abstract

Yearly, approximately 7200 Dutch women with non-palpable breast lesions are referred for a diagnostic surgical excision biopsy. Recently, less invasive alternatives such as stereotactic large-core-needle biopsy have emerged. The aim of this study was to compare the costs of surgical excision biopsy and large-core-needle biopsy. As stereotactic equipment is expensive, the costs of large-core-needle biopsy depend on the extent of centralisation of this facility. Therefore, we assessed the extent of economies of scale in four different scenarios of (de)centralisation. We collected cost data in five Dutch hospitals. The cost of surgical excision biopsy amounted to 1184 Euros. In cases where large-core-needle biopsy would be employed decentralised in all 114 hospitals in The Netherlands, the average costs were estimated to be 1186 Euros compared with 572 Euros in a centralised scenario with involvement of 10 hospitals. Therefore, centralisation of stereotactic equipment for core-needle biopsies would be advisable from an economic perspective.

Keywords: Costs and costs analysis, Hospital economics, Breast neoplasms, Biopsy, Needle, Diagnostic techniques, Surgical