Tomosynthesis could be cost-effective for Breast Cancer Detection

Lee at al in their article in Radiology report on the effectiveness of combined biennial digital mammography and tomosynthesis, compared with biennial digital mammography alone to screen women aged 50-74 with dense breasts for breast cancer.

For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis.

Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50–74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations versus $139 for digital mammography alone) and if the reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice.

They concluded biennial digital mammography combined with tomosynthesis screening for women aged 50–74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations versus $139 for digital mammography alone) and if specificity reported from tomosynthesis is achieved among the many practices across the country.