Mammography + Tomosynthesis Cost-Effective for Dense Breasts

Combined screening cost-effective over range of incremental improvements in test performance

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Combined biennial digital mammography and tomosynthesis screening is effective for women with dense breasts, according to a study published online Oct. 28 in Radiology.

Christoph I. Lee, M.D., M.S.H.S., from the University of Washington in Seattle, and colleagues examined the effectiveness of combined biennial digital mammography and tomosynthesis screening versus biennial digital mammography alone for women aged 50 to 74 years with dense breasts. The comparative clinical effectiveness and cost-effectiveness was assessed in an established, discrete-event breast cancer simulation model.

The researchers found that the incremental cost per quality-adjusted life-year gained by adding tomosynthesis to digital mammography screening was $53,893 for the base-case analysis. After 12 rounds of screening, an additional 0.5 deaths were averted and 405 false-positive findings avoided per 1,000 women. Over a wide range of incremental improvements in test performance, the combined screening remained cost-effective (less than $100,000 per quality-adjusted life-year gained). Cost-effectiveness was most sensitive to tomosynthesis cost.

"Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50 to 74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations versus $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice," the authors write.

Several authors disclosed financial ties to the medical device and health care industries.

Abstract
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