Tsai HY, Huang ST, Chao MF, et al. - In this research, the potential cost-savings of stereotactic vacuum-assisted biopsy (SVAB) over open surgical biopsy (OSB) was evaluated in diagnosis of nonpalpable lesions on mammography and to estimate the cost-saving effect on lesions at different levels of malignant probability. The Institutional Review Board approved this retrospective study. A total of 276 (33.8%) SVAB and 541 (66.2%) OSB medical records were retrospectively reviewed at a medical center. Patients’ self-paid and national health insurance claim charges were included by direct costs. Sick days, average salary, and age-adjusted employment rate were applied to estimate indirect costs. For nonpalpable breast lesions, SVAB was found to be a cost-effective diagnostic option. The study found greater cost-saving effect for the lesions of category 4A and category 3.