Economic potential of abbreviated breast MRI for screening women with dense breast tissue for breast cancer.
Breast neoplasms
Cost-effectiveness analysis
Magnetic resonance imaging
Mammography
Screening
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
02
09
2021
accepted:
24
03
2022
revised:
13
02
2022
pubmed:
29
4
2022
medline:
19
11
2022
entrez:
28
4
2022
Statut:
ppublish
Résumé
Abbreviated breast MRI (AB-MRI) was introduced to reduce both examination and image reading times and to improve cost-effectiveness of breast cancer screening. The aim of this model-based economic study was to analyze the cost-effectiveness of full protocol breast MRI (FB-MRI) vs. AB-MRI in screening women with dense breast tissue for breast cancer. Decision analysis and a Markov model were designed to model the cumulative costs and effects of biennial screening in terms of quality-adjusted life years (QALYs) from a US healthcare system perspective. Model input parameters for a cohort of women with dense breast tissue were adopted from recent literature. The impact of varying AB-MRI costs per examination as well as specificity on the resulting cost-effectiveness was modeled within deterministic sensitivity analyses. At an assumed cost per examination of $ 263 for AB-MRI (84% of the cost of a FB-MRI examination), the discounted cumulative costs of both MR-based strategies accounted comparably. Reducing the costs of AB-MRI below $ 259 (82% of the cost of a FB-MRI examination, respectively), the incremental cost-effectiveness ratio of FB-MRI exceeded the willingness to pay threshold and the AB-MRI-strategy should be considered preferable in terms of cost-effectiveness. Our preliminary findings indicate that AB-MRI may be considered cost-effective compared to FB-MRI for screening women with dense breast tissue for breast cancer, as long as the costs per examination do not exceed 82% of the cost of a FB-MRI examination. • Cost-effectiveness of abbreviated breast MRI is affected by reductions in specificity and resulting false positive findings and increased recall rates. • Abbreviated breast MRI may be cost-effective up to a cost per examination of 82% of the cost of a full protocol examination. • Abbreviated breast MRI could be an economically preferable alternative to full protocol breast MRI in screening women with dense breast tissue.
Identifiants
pubmed: 35482122
doi: 10.1007/s00330-022-08777-5
pii: 10.1007/s00330-022-08777-5
pmc: PMC9668927
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
7409-7419Informations de copyright
© 2022. The Author(s).
Références
Riedl CC, Luft N, Bernhart C et al (2015) Triple-modality screening trial for familial breast cancer underlines the importance of magnetic resonance imaging and questions the role of mammography and ultrasound regardless of patient mutation status, age, and breast density. J Clin Oncol 33:1128–1135. https://doi.org/10.1200/JCO.2014.56.8626
Sardanelli F, Podo F, Santoro F et al (2011) Multicenter surveillance of women at high genetic breast cancer risk using mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (the High Breast Cancer Risk Italian 1 Study): final results. Invest Radiol 46:94–105. https://doi.org/10.1097/RLI.0b013e3181f3fcdf
Kuhl C, Weigel S, Schrading S et al (2010) Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA Trial. J Clin Oncol 28:1450–1457. https://doi.org/10.1200/JCO.2009.23.0839
doi: 10.1200/JCO.2009.23.0839
Sardanelli F, Aase HS, Álvarez M, et al (2017) Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey. Eur Radiol 27:2737–2743. 10.1007/s00330-016-4612-z
Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316. https://doi.org/10.1016/j.ejca.2010.02.015
Mann RM, Balleyguier C, Baltzer PA et al (2015) Breast MRI: EUSOBI recommendations for women’s information. Eur Radiol 25:3669–3678. https://doi.org/10.1007/s00330-015-3807-z
doi: 10.1007/s00330-015-3807-z
Comstock CE, Gatsonis C, Newstead GM et al (2020) Comparison of abbreviated breast MRI vs digital breast tomosynthesis for breast cancer detection among women with dense breasts undergoing screening. JAMA 323:746. https://doi.org/10.1001/jama.2020.0572
doi: 10.1001/jama.2020.0572
Bakker MF, de Lange SV, Pijnappel RM et al (2019) Supplemental MRI screening for women with extremely dense breast tissue. N Engl J Med 381:2091–2102. https://doi.org/10.1056/NEJMoa1903986
doi: 10.1056/NEJMoa1903986
Boyd NF, Guo H, Martin LJ et al (2007) Mammographic density and the risk and detection of breast cancer. N Engl J Med 356:227–236. https://doi.org/10.1056/NEJMoa062790
doi: 10.1056/NEJMoa062790
Kuhl CK, Schrading S, Strobel K et al (2014) Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI. J Clin Oncol Off J Am Soc Clin Oncol 32:2304–2310. https://doi.org/10.1200/JCO.2013.52.5386
doi: 10.1200/JCO.2013.52.5386
Kul S, Metin Y, Kul M et al (2018) Assessment of breast mass morphology with diffusion-weighted MRI: beyond apparent diffusion coefficient. J Magn Reson Imaging 48:1668–1677. https://doi.org/10.1002/jmri.26175
Yamada T, Kanemaki Y, Okamoto S, Nakajima Y (2018) Comparison of detectability of breast cancer by abbreviated breast MRI based on diffusion-weighted images and postcontrast MRI. Jpn J Radiol 36:331–339. https://doi.org/10.1007/s11604-018-0731-6
doi: 10.1007/s11604-018-0731-6
Goto M, Sakai K, Yokota H et al (2019) Diagnostic performance of initial enhancement analysis using ultra-fast dynamic contrast-enhanced MRI for breast lesions. Eur Radiol 29:1164–1174. https://doi.org/10.1007/s00330-018-5643-4
doi: 10.1007/s00330-018-5643-4
Strahle DA, Pathak DR, Sierra A et al (2017) Systematic development of an abbreviated protocol for screening breast magnetic resonance imaging. Breast Cancer Res Treat 162:283–295. https://doi.org/10.1007/s10549-017-4112-0
doi: 10.1007/s10549-017-4112-0
Kaiser CG, Dietzel M, Vag T, Froelich MF (2020) Cost-effectiveness of MR-mammography vs conventional mammography in screening patients at intermediate risk of breast cancer - a model-based economic evaluation. Eur J Radiol:109355. https://doi.org/10.1016/j.ejrad.2020.109355
Froelich MF, Kaiser CG (2020) Cost-effectiveness of MR-mammography as a solitary imaging technique in women with dense breasts: an economic evaluation of the prospective TK-Study. Eur Radiol. https://doi.org/10.1007/s00330-020-07129-5
Tollens F, Baltzer PAT, Dietzel M et al (2021) 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? Cancers 13. https://doi.org/10.3390/cancers13061241
Pisano ED, Hendrick RE, Yaffe MJ et al (2008) Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST. Radiology 246:376–383. https://doi.org/10.1148/radiol.2461070200
doi: 10.1148/radiol.2461070200
Leach MO, Boggis CRM, Dixon AK et al (2005) Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet 365:1769–1778. https://doi.org/10.1016/S0140-6736(05)66481-1
Kuhl CK, Schrading S, Leutner CC et al (2005) Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 23:8469–8476. https://doi.org/10.1200/JCO.2004.00.4960
doi: 10.1200/JCO.2004.00.4960
Richardson LC (2016) Patterns and trends in age-specific black-white differences in breast cancer incidence and mortality – United States, 1999–2014. MMWR Morb Mortal Wkly Rep 65:. 10.15585/mmwr.mm6540a1
Sanders GD, Neumann PJ, Basu A et al (2016) Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. JAMA 316:1093–1103. https://doi.org/10.1001/jama.2016.12195
doi: 10.1001/jama.2016.12195
Fleming MM, Hughes DR, Golding LP et al (2019) Digital breast tomosynthesis implementation: considerations for emerging breast cancer screening bundled payment models. J Am Coll Radiol 16:902–907. https://doi.org/10.1016/j.jacr.2018.11.025
doi: 10.1016/j.jacr.2018.11.025
Hunter SA, Morris C, Nelson K et al (2017) Digital breast tomosynthesis: cost-effectiveness of using private and Medicare insurance in community-based health care facilities. AJR Am J Roentgenol 208:1171–1175. https://doi.org/10.2214/AJR.16.16987
doi: 10.2214/AJR.16.16987
Blumen H, Fitch K, Polkus V (2016) Comparison of treatment costs for breast cancer, by tumor stage and type of service. Am Health Drug Benefits 9:23–32
Brady MJ, Cella DF, Mo F et al (1997) Reliability and validity of the functional assessment of cancer therapy-breast quality-of-life instrument. J Clin Oncol Off J Am Soc Clin Oncol 15:974–986. https://doi.org/10.1200/JCO.1997.15.3.974
doi: 10.1200/JCO.1997.15.3.974
Ahern CH, Shih Y-CT, Dong W et al (2014) Cost-effectiveness of alternative strategies for integrating MRI into breast cancer screening for women at high risk. Br J Cancer 111:1542–1551. https://doi.org/10.1038/bjc.2014.458
doi: 10.1038/bjc.2014.458
Polsky D, Mandelblatt JS, Weeks JC et al (2003) Economic evaluation of breast cancer treatment: considering the value of patient choice. J Clin Oncol 21:1139–1146. https://doi.org/10.1200/JCO.2003.03.126
doi: 10.1200/JCO.2003.03.126
Arias E (2019) United States Life Tables, 2017. Natl Vital Stat Rep 68:1–66
Wishart GC, Azzato EM, Greenberg DC et al (2010) PREDICT: a new UK prognostic model that predicts survival following surgery for invasive breast cancer. Breast Cancer Res 12:R1. https://doi.org/10.1186/bcr2464
Lombardi A, Pastore E, Maggi S et al (2019) Positive margins (R1) risk factors in breast cancer conservative surgery. Breast Cancer (Dove Med Press) 11:243–248. https://doi.org/10.2147/BCTT.S210788
Heil J, Rauch G, Szabo AZ et al (2013) Breast cancer mastectomy trends between 2006 and 2010: association with magnetic resonance imaging, immediate breast reconstruction, and hospital volume. Ann Surg Oncol 20:3839–3846. https://doi.org/10.1245/s10434-013-3097-0
doi: 10.1245/s10434-013-3097-0
Husereau D, Drummond M, Petrou S et al (2013) Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Value Health 16:e1–e5. https://doi.org/10.1016/j.jval.2013.02.010
Husereau D, Drummond M, Petrou S et al (2013) Consolidated Health Economic Evaluation Reporting Standards (CHEERS)--explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value Health 16:231–250. https://doi.org/10.1016/j.jval.2013.02.002
Kaiser CG, Dietzel M, Vag T et al (2021) Impact of specificity on cost-effectiveness of screening women at high risk of breast cancer with magnetic resonance imaging, mammography and ultrasound. Eur J Radiol 137:109576. https://doi.org/10.1016/j.ejrad.2021.109576
doi: 10.1016/j.ejrad.2021.109576
Cameron D, Ubels J, Norström F (2018) On what basis are medical cost-effectiveness thresholds set? Clashing opinions and an absence of data: a systematic review. Glob Health Action 11:. https://doi.org/10.1080/16549716.2018.1447828
Woods B, Revill P, Sculpher M, Claxton K (2016) Country-level cost-effectiveness thresholds: initial estimates and the need for further research. Value Health 19:929–935. https://doi.org/10.1016/j.jval.2016.02.017
doi: 10.1016/j.jval.2016.02.017
Perry N, Broeders M, de Wolf C et al (2008) European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition--summary document. Ann Oncol 19:614–622. https://doi.org/10.1093/annonc/mdm481
Benndorf M, Baltzer PAT, Vag T et al (2010) Breast MRI as an adjunct to mammography: does it really suffer from low specificity? a retrospective analysis stratified by mammographic BI-RADS classes. Acta Radiol 51:715–721. https://doi.org/10.3109/02841851.2010.497164
doi: 10.3109/02841851.2010.497164
Geuzinge HA, Bakker MF, Heijnsdijk EAM et al (2021) Cost-effectiveness of magnetic resonance imaging screening for women with extremely dense breast tissue. J Natl Cancer Inst djab119. https://doi.org/10.1093/jnci/djab119
Veenhuizen SGA, de Lange SV, Bakker MF et al (2021) Supplemental breast MRI for women with extremely dense breasts: results of the second screening round of the DENSE Trial. Radiology 203633. https://doi.org/10.1148/radiol.2021203633
Filli L, Ghafoor S, Kenkel D et al (2016) Simultaneous multi-slice readout-segmented echo planar imaging for accelerated diffusion-weighted imaging of the breast. Eur J Radiol 85:274–278. https://doi.org/10.1016/j.ejrad.2015.10.009
doi: 10.1016/j.ejrad.2015.10.009