Some may benefit from combined mammography and magnetic resonance imaging

Abstract

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 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.