Andre Mattar, Ana Luiza A Faria, Jorge Y Shida, Flávio S Castro, Marcio Sakita, Maria Isabela BAC Sawada, Fábio M Laginha, Luiz H Gebrim


Institution: Hospital Perola Byington

Goals: To describe the results of 1081 breast vacuum assisted percutaneous biopsies (VAB) performed in mammographic alterations (BiradsR 4 and 5) held at Perola Byington Hospital and compare the cost of this procedure with the standard cost of needle guided surgery in the same institution. Methodology: We have reviewed the results of 1081 cases of percutaneous biopsy guided by mammography carried out between April 2012 and December 2015. We compared the cost of the procedure with the cost of surgery, standard procedure before the introduction of stereotactic biopsy procedure in our hospital. We added 15% of new procedure when conventional procedure was done becouse in this cases we needed reintervention when we could not make sure of the final dianosis, especially in the axillary surgical approach. results: The biopsy results were benign in 65% of cases, precursor lesions in 5% and malignant in 30% (with 5% of invasive disease and 25% of in situ – DCIS). Four hundred and nineteen patients underwent surgery after percutaneous biopsy, and 321 for malignant diagnosis (66 invasive and 255 in situ) and 49 precursor lesions (ductal and lobular atypical hyperplasia and flat epithelial atypia) and 49 with benign results but with a discordance between pathological finding and the mamographic image. The cost of diagnostic procedure (VAC) was estimated at R $ 1,160.00 for benign and malignant 1,530.00 results for results and precursor lesions (since there is the cost of immunohistochemistry in the last group). The cost of the surgical procedure both for diagnosis and for treatment was estimated at R $ 2,675.00 for benign surgeries and R $ 5,715.00 for surgeries with malignant results (Becouse of the length of hospitalization is higher in malignant diagnoses). Conclusion: In evaluating the 1081 cases of VAB we achieved a total cost of R $ 1,456,550.00 and adding to cases that need surgical complementation arrived at a total estimated cost of R $ 2,837,264.00. If we did not have this method and had used the surgical procedure inicially the estimated cost would be R $ 4,194,695.00 therefore a 48% higher cost. Thus the implementation of the latest technology with precise indications can reduce the cost of surgical treatment of patients with breast cancer.

Key words: Vacuum Assisted Breast Percutaneous biopsy, breast cancer, costs