Abstract PS1-06-19: A COST-MINIMIZATION ANALYSIS OF VACUUM-ASSISTED BIOPSY (VAB) VERSUS SURGICAL BIOPSY (SB) IN WOMEN ELIGIBLE FOR BREAST CANCER SCREENING: BRAZILIAN PUBLIC HEALTH SYSTEM, HOSPITAL’S AND SOCIETAL PERSPECTIVES

Abstract Introduction: Breast cancer is the leading cause of cancer-related morbidity among women globally and represents a significant burden on health systems, particularly in low- and middle-income countries (LMICs) such as Brazil. Surgical biopsy (SB) and vacuum-assisted biopsy (VAB) are both widely employed for the evaluation of suspicious breast lesions. While SB remains the more established and broadly implemented modality in public settings due to its lower acquisition cost and infrastructure requirements, VAB has gained attention for its enhanced diagnostic performance—enabling larger tissue sampling, improved lesion targeting, and reduced rates of diagnostic underestimation and repeat procedures. The economic implications of adopting VAB over SB remain insufficiently studied in LMICs, where healthcare budgets are constrained and decision-makers must balance cost containment with the pursuit of higher-value care. Objective: The objective of the study was to assess whether VAB or SB would provide better resource allocation in Brazil. Methods: Considering the Brazilian Public Health System (SUS), Hospital and Societal perspectives, a decision tree was modelled using retrospective data of women with breast cancer from 1,833 procedures performed at Pérola Byington Hospital (PBH), which included data on pathological outcomes and the proportion of patients requiring a subsequent lumpectomy. The costs were retrieved from SIGTAP platform, PBH and the societal perspective included costs from official sources of national average salary. Results: VAB kit costs was $382, while SB was considerably lower, ranging from $ 86 to $196 (HPB and Societal perspectives). Through modelling, the total average cost per patient was $268 for VAB and $492 for SB, considering the PBH perspective, resulting in average savings of $223 per patient. Considering the SUS perspective, the average cost was $208 for VAB and $62 for SB, representing a cost increase of $146. From the societal perspective, VAB led to savings of $353 per patient, largely due to fewer workdays lost compared to SB. Conclusion: VAB minimizes the costs against SB, considering the perspectives from PBH and society. While the SUS perspective shows a slight increase in cost, the overall findings support the economic benefit of using VAB, particularly in settings focused on efficiency and patient recovery. Citation Format: A. Amorim, M. Mattar, M. Antonini, M. Teixeira, M. Ramos, R. Lopes, L. Damous, L. Gebrim. A COST-MINIMIZATION ANALYSIS OF VACUUM-ASSISTED BIOPSY (VAB) VERSUS SURGICAL BIOPSY (SB) IN WOMEN ELIGIBLE FOR BREAST CANCER SCREENING: BRAZILIAN PUBLIC HEALTH SYSTEM, HOSPITAL’S AND SOCIETAL PERSPECTIVES [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-06-19.