Some may benefit from combined mammography and magnetic resonance imaging
Article first published online: 23 AUG 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 17, page 3985, 1 September 2010
How to Cite
Printz, C. (2010), Some may benefit from combined mammography and magnetic resonance imaging. Cancer, 116: 3985. doi: 10.1002/cncr.25572
- Issue published online: 23 AUG 2010
- Article first published online: 23 AUG 2010
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.