[Cost-effectiveness of percutaneous core needle breast biopsy (CNBB) versus open surgical biopsy (OSB) of nonpalpable breast lesions: metaanalysis and cost evaluation for German-speaking countries].

PURPOSE: To analyze the cost-effectiveness of percutaneous image-guided CNBB (stereotactic-/ultrasound-guided; large/vacuum-assisted) of non-palpable breast lesions vs. OSB and to compare and discuss the results reported in the literature with results for German-speaking countries. MATERIALS AND METHODS: A key word search in three databases, limited to the period from 1 / 1994 to 12 / 2006 was performed. Only original papers were selected. No published articles for German-speaking countries were identified; therefore a comprehensive data collection was made. RESULTS: On the basis of 377 abstracts, nine studies were evaluated for final assessment. The data of German-speaking countries were compared with results reported in the literature. This study demonstrates that CNBB compared to OSB leads to reduction in cost ranging from 51 - 96 %. The cost reduction depends on biopsy modality and lesion type and is subject to national fluctuations. CNBB can replace a surgical procedure in 71 - 85 % of cases. CONCLUSION: Use of CNBB as an alternative to OSB has the potential to substantially reduce healthcare costs. The data are based almost exclusively on the North American literature. A potential cost reduction in the Netherlands and Switzerland confirms these findings. Future work must include cost evaluation studies for German-speaking countries since this is an issue with important national economic ramifications.