Hospital charges for inpatients undergoing breast biopsy were 1.9 times higher than for outpatients. Outpatient biopsy reduced length of stay from 2.7 days to 6.3 hours, provided psychological benefits, minimally disrupted family life, and did not compromise medical care.
Substantial unnecessary hospital costs resulted from extensive preoperative medical evaluation and preparation for possible mastectomy plus screening for metastases in patients admitted with benign disease.
Screening studies to detect metastases (bone survey, bone scan, liver scan) were performed in 45% of patients with carcinoma. No metastases were demonstrated when not suspected clinically. These data suggest that time-consuming and expensive screening studies for metastatic disease are not warranted.
A treatment strategy, which includes outpatient biopsy only for undiagnosed breast lesions and a specified preoperative assessment prior to admission for biopsy-proven breast carcinoma, has been defined.