Cost-effectiveness of digital breast tomosynthesis vs. abbreviated breast MRI for screening women with intermediate risk of breast cancer: how low-cost must MRI be?
Background: Digital breast tomosynthesis (DBT) and abbreviated breast MRI (AB-MRI) offer superior diagnostic performance compared to conventional mammography in screening women with intermediate risk of breast cancer due to dense breast tissue. The aim of this model-based economic evaluation was to...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
12 March 2021
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| In: |
Cancers
Year: 2021, Volume: 13, Issue: 6, Pages: 1-14 |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers13061241 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers13061241 Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/13/6/1241 
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| Author Notes: | Fabian Tollens, Pascal A.T. Baltzer, Matthias Dietzel, Johannes Rübenthaler, Matthias F. Froelich and Clemens G. Kaiser |
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| 245 | 1 | 0 | |a Cost-effectiveness of digital breast tomosynthesis vs. abbreviated breast MRI for screening women with intermediate risk of breast cancer |b how low-cost must MRI be? |c Fabian Tollens, Pascal A.T. Baltzer, Matthias Dietzel, Johannes Rübenthaler, Matthias F. Froelich and Clemens G. Kaiser |
| 246 | 1 | |i Titel des Special issues |a Novel insights into biology and cancers | |
| 246 | 3 | 3 | |a Cost-effectiveness of digital breast tomosynthesis versus abbreviated breast MRI for screening women with intermediate risk of breast cancer |
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| 520 | |a Background: Digital breast tomosynthesis (DBT) and abbreviated breast MRI (AB-MRI) offer superior diagnostic performance compared to conventional mammography in screening women with intermediate risk of breast cancer due to dense breast tissue. The aim of this model-based economic evaluation was to analyze whether AB-MRI is cost-effective in this cohort compared to DBT. Methods: Decision analysis and Markov simulations were used to model the cumulative costs and quality-adjusted life-years (QALYs) over a time horizon of 30 years. Model input parameters were adopted from recent literature. Deterministic and probabilistic sensitivity analyses were applied to test the stability of the model. Results: In the base-case scenario, the costs of an AB-MRI examination were defined to equal the costs of a full protocol acquisition. Two-yearly screening of women with dense breasts resulted in cumulative discounted costs of $8798 and $9505 for DBT and AB-MRI, and cumulative discounted effects of 19.23 and 19.27 QALYs, respectively, with an incremental cost-effectiveness ratio of $20,807 per QALY gained in the base-case scenario. By reducing the cost of an AB-MRI examination below a threshold of $241 in sensitivity analyses, AB-MRI would become cost-saving compared to DBT. Conclusion: In comparison to DBT, AB-MRI can be considered cost-effective up to a price per examination of $593 in screening patients at intermediate risk of breast cancer. | ||
| 650 | 4 | |a AB-MRI | |
| 650 | 4 | |a breast cancer | |
| 650 | 4 | |a cost-effectiveness analyses | |
| 650 | 4 | |a cost-effectiveness threshold | |
| 650 | 4 | |a intermediate-risk screening | |
| 650 | 4 | |a MR-Mammography | |
| 650 | 4 | |a tomosynthesis | |
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