Abstract
Purpose
This study was undertaken to compare the cost effectiveness of two vacuum-assisted breast biopsy devices, the Mammotome and Vacora systems.
Materials and methods
Between January and June 2006, 238 vacuum-assisted breast biopsies were performed at our radiology department. Five out of 238 lesions were excluded because of inadequate sampling. The Mammotome system was used in 108/233 lesions and the Vacora system in 125/233. Fifty-eight lesions underwent ultrasound-guided breast biopsy, and 50 lesions underwent mammography-guided biopsy with both Mammotome and Vacora devices. Magnetic-resonance-guided biopsy was possible with the Vacora system only (17/125 lesions).
Results
All procedures were successfully completed. No significant differences were found between the results of the Mammotome and Vacora biopsies in terms of effectiveness: sensitivity was 84.4% and 86.2%, respectively, and specificity 100%. In terms of cost, the Mammotome system has higher costs per procedure compared with the Vacora.
Conclusions
Our clinical results confirm the diagnostic accuracy of both the Mammotome and Vacora systems, whereas our cost analysis shows that there is a considerable difference, mostly related to the initial investment.
Riassunto
Scopo
Confrontare costi ed efficacia di due sistemi di biopsia mammaria ad aspirazione forzata: Mammotome e Vacora.
Materiali e metodi
Presso il nostro Centro, dal gennaio a giugno 2006 sono state sottoposte a caratterizzazione istologica mediante prelievo VAB 238 lesioni mammarie. Di queste 5/238 sono state escluse dalla nostra casistica per numero insufficiente di frustoli prelevati. In 108/233 lesioni è stato utilizzato il sistema Mammotome ed in 125/233 il Vacora. Con entrambi i sistemi sono state sottoposte a prelievo 58 lesioni sotto guida ecografica e 50 sotto guida mammografica. Per la guida RM è stato utilizzato unicamente il sistema Vacora (17/125 lesioni).
Risultati
Tutte le procedure considerate sono state portate a termine con successo. L’efficacia diagnostica dei due sistemi è risultata sovrapponibile: sensibilità 84,4%–86,2%, specificità 100%. I costi unitari delle singole procedure risultano maggiori per il sistema Mammotome, rispetto al Vacora.
Conclusioni
I risultati clinici confermano l’accuratezza diagnostica di entrambi i sistemi mentre, ai fini della valutazione economica delle procedure, il fattore determinante è l’investimento iniziale.
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References/Bibliografia
Pfarl G, Helbich TH, Riedl CC et al. (2002) Stereotactic 11-gauge vacuumassisted breast biopsy: a validation study. AJR Am J Roentgenol 179:1503–1507
Ambrogetti D, Bianchi S, Ciatto S (2003) Accuratezza della biopsia percutanea di calcificazioni isolate identificate alla mammografia. Esperienza con un sistema di biopsia con aspirazione di frustoli mediante vuoto con ago da 11G. Radiol Med 106:313–319
Nori J, Cariti G, Masi A et al. (2001) La microbiopsia istologica con ago da 14 Gauge nella diagnosi delle lesioni mammarie. Esperienza su 1000 casi. Radiol Med 101:31–38
Bazzocchi M, Facecchia I, Zuiani C et al. (1999) Iperplasia duttale atipica della mammella. Diagnostica per immagini e ruolo dell’agobiopsia per cutanea con ago da 14 Gauge. Radiol Med 98:133–137
Liberman L, Sama MP (2000) Costeffectiveness of stereotactic 11-gauge directional vacuum-assisted breast biopsy. AJR Am J Roentgenol 175:53–58
Liberman L, Gougoutas CA, Zakowski MF et al. (2001) Calcifications highly suggestive of malignancy: comparison of breast biopsy methods. AJR Am J Roentgenol 177:165–172
Burkhardt JH, Sunshine JH (1999) Core-needle and surgical breast biopsy: comparison of three methods of assessing cost. Radiology 212:181–188
Golub RM, Bennett CL, Stinson T et al. (2004) Cost minimization study of image-guided core biopsy versus surgical excisional biopsy for women with abnormal mammograms. J Clin Oncol 22:2430–2437
Bodai BI, Boyd B, Brown L et al. (2001) Total cost comparison of 2 biopsy methods for non palpable breast lesions. Am J Manag Care 7:527–538
Simon JR, Kalbhen CL, Cooper RA, Flisak ME (2000) Accuracy and complication rates of US-guided vacuum-assisted core breast biopsy: initial results. Radiology 215:694–697
Perlet C, Heywang-Kobrunner SH, Heinig A et al. (2006) Magnetic resonance-guided, vacuum-assisted breast biopsy. Results from a European Multicenter Study of 538 lesions. Cancer 106:982–990
Hrung JM, Langlotz CP, Orel SG et al. (1999) Cost-effectiveness of MR imaging and core-needle biopsy in the preoperative work-up of suspicious breast lesions. Radiology 213:39–49
Orel SG, Rosen M, Mies C, Schnall MD (2006) MR imaging-guided 9-gauge vacuum-assisted core-needle breast biopsy: initial experience. Radiology 238:54–61
Perretta T, Pistolese CA, Bolacchi F et al. (2008) MR imaging-guided 10 gauge vacuum assisted breast biopsy: histological characterization. Radiol Med 113:830–840
Panizza P, De Cobelli F, De Gaspari A et al. (2003) Valutazione di un sistema stereotassico per la guida RM di biopsie di lesioni mammarie. Aspetti tecnici e risultati preliminari. Radiol Med 106:232–244
Kuhl CK, Elevelt A, Leutner CC et al. (1997) Interventional breast MR imaging: clinical use of a stereotactic localization and biopsy device. Radiology 204:667–675
Piubello Q, Montemezzi S, D’Atri C (2002) Breast calcifications with percutaneous vacuum-assisted diagnosis of malignancy or atipical hyperplasia: correlations with surgical findings. Pathologica 94:299–305
Shiro B (2004) Advantages of Using the VACORA™ Breast Biopsy System-A Pathologist’s Perspective. http://www.bardbiopsy.com/pdf/white_paper.pdf. Accessed 03/2009
Ghate SV, Rosen EL, Soo MS, Baker JA (2006) MRI-guided vacuumassisted breast biopsy with a handheld portable biopsy system. AJR Am J Roentgenol 186:1733–1736
Darling ML, Smith DN, Lester SC et al. (2000) Atypical ductal hyperplasia and ductal carcinoma in situ as revealed by large-core needle breast biopsy: results of surgical excision. AJR Am J Roentgenol 175:1341–1346
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Pistolese, C., Ciarrapico, A., della Gatta, F. et al. Cost-effectiveness analysis of two vacuum-assisted breast biopsy systems: Mammotome and Vacora. Radiol med 114, 743–756 (2009). https://doi.org/10.1007/s11547-009-0404-8
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DOI: https://doi.org/10.1007/s11547-009-0404-8