Recently had a request from hospital commander to address a complaint from a patient. Per this woman’s report, she had a concerning 1 cm breast mass on mammogram and was offered a needle localized breast biopsy by one of my partners. Patient was apprehensive about having an excisional biopsy and elected to seek a second opinion at a civilian facility in the area (about 100 miles away) at a tertiary medical center. There she underwent a Stereotactic Core Needle Biopsy (SCNB) with a benign result. She requested to the commander that our small military facility invest in a stereotactic unit for purposes of breast biopsy. At my hospital, between three general surgeons, we perform on average 0 – 2 breast biopsies per week, of which maybe 25 % are needle localized by mammography.
My questions are:
1.) Anybody have significant experience with SCNB, as well as Stereotactic Fine Needle Aspiration (in light of discussion last week regarding false positive SFNA)?
2.) Is this now considered the “gold standard” or “standard of care” in any community?
3.) Anyone offering this as an option to excisional biopsy?
4.) What is the cost of the procedure? This patient claims it only cost $120 for her to have the procedure. (I think that was her out of pocket costs after insurance picked up the remainder — whatever that amount was). Several articles have suggested that doing SCNB/SFNA (with a reliable pathologist) saves money because less persons (i.e. physicians) are involved in making the diagnosis. Reportedly, the primary care manager and the radiologist are all that need to be involved in benign breast lesions?