Mammography is most cost-effective when frequency is based on breast cancer risk factors
TUESDAY, July 5 (HealthDay News) -- Personalizing the frequency of mammography on the basis of the woman's age, breast density, history of breast biopsy, and family history of breast cancer is cost-effective, according to research published in the July 5 issue of the Annals of Internal Medicine.
John T. Schousboe, M.D., Ph.D., from the Park Nicollet Health Services and University of Minnesota in Minneapolis, and colleagues analyzed the cost-effectiveness of mammography, taking into consideration a woman's age, breast density, history of breast biopsy, family history of breast cancer, and screening interval. U.S. women in the age groups 40 to 49, 50 to 59, 60 to 69, and 70 to 79 years, who underwent an initial mammography at age 40 years, and with a Breast Imaging Reporting and Data System (BI-RADS) breast density category of 1 to 4 were followed up for life. The outcomes studied included costs per quality-adjusted life-year (QALY).
The investigators found that for all women with a BI-RADS category of 3 or 4, all women with both a family history and previous biopsy, women aged 50 to 69 years with a BI-RADS category of 2, and women aged 60 to 79 years with a BI-RADS category of 1 and either a family history or previous biopsy, the biennial mammography cost less than $100,000 per QALY gained. For women aged 40 to 49 years with a BI-RADS category of 3 or 4, the cost per QALY was less than $50,000. An annual mammography was not found to be cost-effective for any group.
"The frequency of screening mammography should be personalized on the basis of a woman's breast density, age, family history of breast cancer, and history of breast biopsy," the authors write.
The study was partially funded by Eli Lilly.
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