Evaluation of directional vacuum-assisted breast biopsy: Report for the National Breast Cancer Centre final report, CHERE Project Report No 21
Breast cancer, diagnostics, breast biopsy, Australia
This project was commissioned by the National Breast Cancer Centre (NBCC). The objectives of the project, as set out in the call for expressions of interest, were to determine: 1. The costs associated with the introduction and use of directional vacuum-assisted breast biopsy(DVA breast biopsy) in Australia; and 2. Whether directional vacuum-assisted breast biopsy used for diagnostic purposes is cost-effectivein Australia when compared to core biopsy. The motivation for commissioning the project was an assessment of directional vacuum-assisted breast biopsy conducted by the Medical Services Advisory Committee (MSAC) which concluded that the procedure is safe and more effective than core biopsy. Although a cost-effectiveness analysis was not conducted as part of the MSAC study, MSAC recommended that the costs associated with the procedure be investigated and that, pending a review of costs, the procedure receive interim Medicare funding at a higher level than was previously available. For the project reported here, data was required to be collected from both public and private sectors on the cost of introducing and using DVA breast biopsy and a cost-effectiveness analysis (CEA) conducted on the introduction and use of DVA breast biopsy with and without a prone table. The research question for the CEA was What is the impact on costs and number of open biopsies performed of using DVA breast biopsy compared to core biopsy for micro-calcification lesions? It is important to note that this question specifies both the outcome the CEA (change in the number of core biopsies performed) and that the investigation was to be confined to micro-calcification lesions only. An expert multidisciplinary working group was assembled to oversee the project. Following collection of data an interim report was produced for the working group. As DVABB is a relatively new technology in Australia the interim report indicated that the current number of sites performing DVABB and the level of experience of users was insufficient to provide meaningful data to achieve the project aims. On the advice of the working group it was agreed to suspend the project at this juncture. The NBCC will consider repeating the survey in the future.