Cost-effectiveness of MRI vs Mammography for Breast Cancer Screening
Author Information
Author(s): Moore Susan G, Shenoy Pareen J, Fanucchi Laura, Tumeh John W, Flowers Christopher R
Primary Institution: Emory University
Hypothesis
Is breast MRI a cost-effective approach for detecting breast cancer among high-risk young women?
Conclusion
Breast MRI may provide health benefits for some high-risk women, but it is not cost-effective compared to mammography.
Supporting Evidence
- Breast MRI provided 14.1 QALYs at a cost of $18,167, while mammography provided 14.0 QALYs at a cost of $4,760.
- The incremental cost-effectiveness ratio of breast MRI compared to mammography was $179,599/QALY.
- Breast MRI screening was superior in 0%, < $50,000/QALY in 22%, > $50,000/QALY in 34%, and inferior in 44% of trials.
Takeaway
This study looked at whether using MRI instead of mammograms for breast cancer screening is worth the extra money for women at high risk. It found that while MRI is better at finding cancer, it costs too much compared to mammograms.
Methodology
A Markov model was created to compare annual breast cancer screening over 25 years with either breast MRI or mammography.
Potential Biases
Selection bias may affect the model's effectiveness and resource use estimates.
Limitations
The model did not incorporate all relevant factors affecting cost-effectiveness, such as anxiety from false positives and the costs of radiation exposure.
Participant Demographics
Young women at high risk for breast cancer, particularly those with a family history or genetic predisposition.
Statistical Information
Confidence Interval
95% central range: -0.767 QALYs to +0.439 QALYs
Digital Object Identifier (DOI)
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