Annual mammography and magnetic resonance imaging (MRI) screening may be a cost-effective way to improvelife expectancy for those women at an increased riskof developing breast cancer, according to a study publishedin Radiology.1

Lead author Janie M. Lee, MD, a radiologist at MassachusettsGeneral Hospital in Boston, and her colleagues comparedthe costs and benefits of film mammography alone,MRI alone, and combined mammography and MRI in a hypotheticalgroup of 25-year-old women with BRCA1 mutations.They used statistical modeling to estimate thenumber of quality-adjusted life years (QALYs) gained byscreening , along with lifetime costs.The results were:

  • A gain of 49.62 QALYs at a lifetime cost of $110,973for women undergoing the combined screening;

  • A gain of 49.50 QALYs at a lifetime cost of $108,641for annual MRI alone; and

  • A gain of 44.46 QALYs at a lifetime cost of $100,336for mammography alone.

Commonly cited threshold values for cost-effective interventionsrange from $50,000to $100,000 per QALY, andadding MRI to annual mammographyscreening costs $69,125for each additional QALY, which supports the cost-effectivenessof the combined screenings, says Dr. Lee.

The combined screenings were also best at detectingearly stage cancers and providing the greatest relative mortalityreduction . It became more cost-effective as breastcancer risk increased. However, adding MRI was found toincrease the number of false-positive results to 137 foreach avoided breast cancer death. Thus, the benefits ofMRI are balanced by an increased chance of the need foradditional tests, including biopsies, Dr. Lee adds.


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  2. Reference
  • 1
    Lee JM, McMahon PM, Kong CY, et al. Cost-effectiveness of breast MR imagingand screen-film mammography for screening BRCA1 gene mutation carriers. Radiology. 2010; 254: 793-800.