The purpose of this study was to analyze the use of stereotactic percutaneous breast biopsy in the treatment of nonpalpable breast abnormalities. In addition, we set out to compare the results of both radiologists and surgeons performing the procedure and to provide an estimation of the cost per patient. A retrospective analysis of the use of stereotactic core biopsy (SCBx) to diagnose suspicious breast lesions was performed in 193 patients between December 1995 and February 1997. The study group was compared to a similar group of 106 patients who had needle localization excisional biopsy (NleBx) performed during the same period. Statistical analysis between surgeons and radiologists was performed for the percutaneous procedures. Allowable charges for both specialists were used to compare percutaneous biopsy with open biopsy. Stereotactic percutaneous breast biopsy performed at our institution by either the surgeon or radiologist is an accurate and cost-effective way to evaluate nonpalpable breast abnormalities and saves approximately $1500-$2500 per patient as compared with needle localization excisional biopsy. Adequately trained surgeons and radiologists can achieve similar accuracy in utilizing this new technology for breast diagnosis.