OBJECTIVES:  Fibroadenoma of the breast is most common in young women in their 20s and 30s, but can be found in women of any age. Fibroadenomas can cause physical deformity, discomfort and emotional distress, and as a result, are often removed. Two of the most common approaches to removing Fibroadenomas are surgical excision and percutaneous excision via Vacuum Assisted Biopsy (VAB). While open surgical excision is effective, it can be very costly due to operating room charges. Additionally, it can also lead to negative outcomes such as bruising, swelling, scarring and possibly infection. VAB has been shown to be safe and highly effective at removing Fibroadenomas. It offers significant advantages to the patient including minimal morbidity, scarring, reduced re-biopsy rates and cost. METHODS:  A retrospective analysis of both Surgical Excision and VAB procedures from the Premier Hospital Database was conducted. The economic outcomes of patients whose discharge data included CPT codes for VABB procedures 19083 and surgical excision procedures 19101, 19120, 19125 were evaluated in the outpatient setting. Adult patients (>18) with a procedure between 1/2014-12/2014 were evaluated. Total costs for the procedure, re-operations and clinical complications were collected. RESULTS: The analysis produced cohorts of 24,479 for Surgical Excision and 30,067 for VAB. Average age for Surgical Excision was 51.50, SD 17.03 and for VAB was 54.44, SD 15.29. Cost of VAB was associated with a lower all-cause cost of $1,755.77 ($1,152, SD $4,102.01 VAB vs $2,908.66, SD $2,110.33 Surgery); readmission rates for Surgical Excision was 11-17% of cases while for VAB was 4-9%. CONCLUSIONS: Lower healthcare utilization and outpatient hospital cost was found to be associated with the use of VAB compared to Surgical Excision. The research shows that VAB can be cost saving and have better patient outcomes compared with Surgical Excision for Fibroadenomas of the breast.