Combined Screening for BRCA1 Mutation Carriers Found Useful

Annual screen-film mammography with magnetic resonance imaging linked with improved survival
By Eric Metcalf
HealthDay Reporter

MONDAY, March 8 (HealthDay News) -- In women with BRCA1 mutations, the use of annual screen-film mammography along with magnetic resonance imaging (MRI) provides a better gain in life expectancy, and could prove cost-effective if the value placed on gaining an additional quality-adjusted life-year (QALY) is within $50,000 to $100,000, according to research published in the March issue of Radiology.

Janie M. Lee, M.D., of the Massachusetts General Hospital in Boston, and colleagues analyzed data from a simulation model that included 25-year-old BRCA1 mutation carriers, and compared annual screen-film mammography, MRI, or a combination of the two. The authors estimated QALYs and lifetime costs.

The researchers found the combination to be most effective, but with the highest lifetime cost (44.62 QALYs and $110,973, respectively). The corresponding figures for MRI were 44.50 and $108,641, and for mammography they were 44.46 and $100,336. The cost of combined screening compared to mammographic screening was $69,125 per QALY, which previous research suggests is cost-effective.

"In summary, annual combined screening for BRCA1 mutation carriers provides the greatest life expectancy gain and is likely cost-effective, when the value placed on gaining an additional QALY is in the range of $50,000 to $100,000. The benefits of screening with increased intensity for these women are likely to outweigh the effects of false-positive screening results," the authors write.

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