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Objectives <p>To evaluate the cost-effectiveness of supplemental breast magnetic resonance imaging (MRI) in women with BI-RADS 4 mammographic microcalcifications in order to avoid unnecessary stereotactic biopsies.</p> Methods <p>Decision analysis and Markov modeling were used to compare the short-term costs and effects of two diagnostic strategies: supplemental breast MRI in women with mammographic microcalcifications to avoid needle biopsies in MRI negative cases vs stereotactic biopsies of all BI-RADS 4 microcalcifications.</p> Results <p>Applying supplemental breast MRI resulted in comparable costs and outcomes. Average cumulative costs of US$ 56,918 and 2.932 quality adjusted life years (QALYs) per woman were achieved for the supplemental breast MRI-strategy, whereas stereotactic biopsies as standard of care resulted in cumulative costs of US$ 56,898 and 2.930 QALYs, resulting in an incremental cost effectiveness ratio (ICER) of US$ 10,047 per QALY gained.</p> Conclusion <p>Due to comparable diagnostic safety at similar costs, the non-invasive breast MRI alternative for workup of mammographically detected suspicious calcifications should be offered to patients within the context of shared decision making.</p> Critical relevance statement <p>Contrast-enhanced MRI of the breast should be offered as an alternative to stereotactic biopsy within the context of shared decision-making.</p> Key Points <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Breast MRI and stereotactic biopsy enable accurate risk stratification of suspicious calcifications.</p> </ItemContent> <ItemContent> <p>Breast MRI and stereotactic biopsy yield comparable cost-effectiveness and clinical outcomes.</p> </ItemContent> <ItemContent> <p>Breast MRI&#xa0;should be considered as an option regarding shared clinical decision-making.</p> </ItemContent> </UnorderedList></p> Graphical Abstract <p></p>

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Cost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcifications

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月12日

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  • Barbara J. Fueger,
  • Fabian Tollens,
  • Clemens G. N. Kaiser,
  • Thomas H. Helbich,
  • Nina Pötsch,
  • Paola Clauser,
  • Pascal A. T. Baltzer

摘要

Objectives

To evaluate the cost-effectiveness of supplemental breast magnetic resonance imaging (MRI) in women with BI-RADS 4 mammographic microcalcifications in order to avoid unnecessary stereotactic biopsies.

Methods

Decision analysis and Markov modeling were used to compare the short-term costs and effects of two diagnostic strategies: supplemental breast MRI in women with mammographic microcalcifications to avoid needle biopsies in MRI negative cases vs stereotactic biopsies of all BI-RADS 4 microcalcifications.

Results

Applying supplemental breast MRI resulted in comparable costs and outcomes. Average cumulative costs of US$ 56,918 and 2.932 quality adjusted life years (QALYs) per woman were achieved for the supplemental breast MRI-strategy, whereas stereotactic biopsies as standard of care resulted in cumulative costs of US$ 56,898 and 2.930 QALYs, resulting in an incremental cost effectiveness ratio (ICER) of US$ 10,047 per QALY gained.

Conclusion

Due to comparable diagnostic safety at similar costs, the non-invasive breast MRI alternative for workup of mammographically detected suspicious calcifications should be offered to patients within the context of shared decision making.

Critical relevance statement

Contrast-enhanced MRI of the breast should be offered as an alternative to stereotactic biopsy within the context of shared decision-making.

Key Points

Breast MRI and stereotactic biopsy enable accurate risk stratification of suspicious calcifications.

Breast MRI and stereotactic biopsy yield comparable cost-effectiveness and clinical outcomes.

Breast MRI should be considered as an option regarding shared clinical decision-making.

Graphical Abstract