Might combining DBT with digital mammography lower your expenses?

The research team, led by Sonya Cressman, PhD, of Simon Fraser University in British Columbia found that adding DBT to digital mammography can result in cost savings in a breast screening program, but only if it affects the Reduction in recall rates.

It has been shown that the combination of DBT with digital mammography reduces the number of false positives and screening costs. There is concern, however, that the extra time radiologists need to interpret more images and the data storage requirements of DBT can result in costs that outweigh the potential savings from the technology.

“Because screening programs perform a high volume of breast exams, the decision to add DBT to DM-based screening requires data-driven analysis of total cost and any associated downstream results,” the authors write.

To answer the question, the team performed a model-based economic analysis based on data from 112,249 screening participants in the British Columbia Cancer Breast Screening program. The decision model simulated lifetime costs and outcomes for breast cancer screening participants who were 40 to 74 years old between 2012 and 2017.

The model assumed that adding DBT to DM screening would cost an additional $ 44 per exam, increase cancer detection rate by 1.6 cancers per 1,000 exams, and decrease recall rate by an absolute 2.2%.

If digital breast tomosynthesis plus digital mammography could reduce absolute recall rates by more than 2.1%, the group’s base scenario would have an incremental cost-benefit ratio of $ 17,149 per quality-adjusted life year (QALY) – well below the standard of $ 100,000, where an intervention is seen as inexpensive.

The model also found that adding DBT to DM screening would result in 0.027 QALY per person, and that benefit comes at an additional cost of $ 470 per person.

“If DBT plus DM lowers absolute recall rates by at least 2.1%, and the additional cost of providing DBT exams is no more than the reimbursement fee set, then the technology is viewed as an inexpensive addition to DM screening,” the authors write .

Cressman told AuntMinnie.com that the findings were based on evidence from the ongoing field Tomosynthesis Mammographic Imaging Screening Study, which compares 2D and 3D mammograms for breast cancer detection. This study is expected to be completed by 2025.

“If DBT increases recall rates, it is unlikely to be considered cost-effective with the radiologist reimbursement fee structure we are referring to,” said Cressman. “The study is complete, with all eyes on the T-MIST study.”

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