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Comparison of the costs of fine‐needle aspiration and open surgical biopsy as methods for obtaining a pathologic diagnosis
Author(s) -
Rimm David L.,
Stastny Janet F.,
Rimm Eric B.,
Ayer Sanjay,
Frable William J.
Publication year - 1997
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970225)81:1<51::aid-cncr11>3.0.co;2-b
Subject(s) - medicine , biopsy , cytopathology , fine needle aspiration , surgery , open biopsy , radiology , needle biopsy , cytology , pathology
BACKGROUND A pathologic diagnosis is usually required to determine definitive management for a palpable lesion. In this era of cost control, fine‐needle aspiration (FNA) provides a low‐cost alternative to open excisional biopsy. Using a broad range of cases collected over 20 years, the authors of this study sought to quantify the savings resulting from the use of FNA on superficial palpable lesions to obtain a pathologic diagnosis. METHODS 12,452 cases collected by the cytopathology service at the Medical College of Virginia during the period 1972‐1991 were used to produce a profile of case type, diagnosis, and indication for surgery. Charge‐based cost estimations or Relative Value Units were calculated using the 1995 Physicians' Fee Reference or published Medicare participant fees. The charges for the FNA procedure and open surgical biopsy were compared, and all other biopsy‐related costs were omitted. RESULTS FNA provided a sufficient pathologic diagnosis to obviate open surgical biopsy in 63‐85% of the cases. Estimation of cost savings on the basis of the distribution of cases and indications for surgery suggested a savings of $250,000 to $750,000 per 1000 FNA performed, or approximately 5500 Relative Value Units. CONCLUSIONS This study quantifies the substantial savings that result from obtaining a pathologic diagnosis by the FNA procedure rather than open surgical biopsy. Cancer (Cancer Cytopathol) 1997; 81:51‐6. © 1997 American Cancer Society.