Cost-Effectiveness Analysis of Breast Cancer Screening Strategies

• Activity Number: 457
• Type: Invited
• Date/Time: Wednesday, August 7, 2013 : 8:30 AM to 10:20 AM
• Sponsor: Biometrics Section
• Author(s): Yu Shen*+
• Companies: UT M D Anderson Cancer Center
• Keywords: breast cancer ; cost-effective ; screening

Abstract

Magnetic resonance imaging (MRI) in addition to mammography was recently recommended for women with high-risk for breast cancer. We conducted a cost-utility analysis to evaluate the optimal method of incorporating MRI into guidelines using mammography and clinical breast exam (CBE) in the high-risk population, defined here as women with greater than a 25% lifetime risk of breast cancer. A microsimulation model was used to generate women's life histories under different risk profiles, and to assess the impact of screening and treatment on survival. We compared multiple screening strategies combining mammography and CBE (or none), with the addition of MRI starting at age 30, and with screening intervals of 0.5, 1, or 2 years. The outcomes were quality-adjusted life years and total costs, both discounted at an annual rate of 3%. Incremental cost-effectiveness ratios (ICERs) were reported. The findings indicate that addition of MRI to mammography and CBE is expensive.