Cost-effectiveness of stereotactic large-core needle biopsy for nonpalpable breast lesions compared to open-breast biopsy

Groenewoud, Johanna H.; Pijnappel, Ruud M.; Marle, M. Elske van den Akker-van; Birnie, Erwin; Woude, T Buijs-van der; Mali, Willem P.Th.M.; Koning, Harry J. de; Buskens, E

doi:10.1038/sj.bjc.6601520

Cited by 32 publications

(17 citation statements)

References 20 publications

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“…The MISCAN model was developed to estimate the costs and effects of the introduction of a nation-wide screening programme in the Netherlands and has been described in detail previously [8][9][10]. In the model, individual life histories are generated as a Markov process of stages and transitions.…”

Section: Second Stagementioning

confidence: 99%

Cost-effectiveness of different reading and referral strategies in mammography screening in the Netherlands

Groenewoud

Otten

Fracheboud

et al. 2006

Breast Cancer Res Treat

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In mammography screening with double reading, different strategies can be used when the readers give discordant recommendations for referral. We investigated whether the results of the Dutch breast cancer screening programme can be optimised by replacing the standard referral strategy by consensus. Twenty-six screening radiologists independently and blinded to outcome read a test set consisting of previous screening mammograms of 250 cases (screen-detected and interval cancers) and 250 controls. Their referral recommendations were paired and, in case of discrepancy, re-read according to three referral strategies: (1) decision by one of the readers; (2) arbitration by a third reader; (3) referral if both readers agree (consensus). Data allowed studying other referral strategies, including referral if any reader suggests, as well. Double reading with referral if any reader suggests resulted in a 1.03 times higher sensitivity (76.6%) and a 1.31 times higher referral rate (1.26%) than double reading with consensus. To estimate the cost-effectiveness, the outcomes were used in a microsimulation model. Even if double reading with referral if any reader suggests results in four times as high referral rates and an accompanying increase of biopsies or other invasive procedures, the cost-effectiveness of 4,190 Euros per life-year gained may well be in the range of acceptable cost-effectiveness for Dutch health care programmes.

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Section: Second Stagementioning

confidence: 99%

Cost-effectiveness of different reading and referral strategies in mammography screening in the Netherlands

Groenewoud

Otten

Fracheboud

et al. 2006

Breast Cancer Res Treat

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“…MISCAN is a well-validated microsimulation model used to evaluate various screening programs (21)(22)(23)(24). In MISCAN, individual life histories are simulated.…”

Section: Miscan Modelmentioning

confidence: 99%

Differences in Natural History between Breast Cancers in BRCA1 and BRCA2 Mutation Carriers and Effects of MRI Screening-MRISC, MARIBS, and Canadian Studies Combined

Heijnsdijk

Warner

Gilbert

et al. 2012

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: It is recommended that BRCA1/2 mutation carriers undergo breast cancer screening using MRI because of their very high cancer risk and the high sensitivity of MRI in detecting invasive cancers. Clinical observations suggest important differences in the natural history between breast cancers due to mutations in BRCA1 and BRCA2, potentially requiring different screening guidelines.Methods: Three studies of mutation carriers using annual MRI and mammography were analyzed. Separate natural history models for BRCA1 and BRCA2 were calibrated to the results of these studies and used to predict the impact of various screening protocols on detection characteristics and mortality.Results: BRCA1/2 mutation carriers (N ¼ 1,275) participated in the studies and 124 cancers (99 invasive) were diagnosed. Cancers detected in BRCA2 mutation carriers were smaller [80% ductal carcinoma in situ (DCIS) or 10 mm vs. 49% for BRCA1, P < 0.001]. Below the age of 40, one (invasive) cancer of the 25 screen-detected cancers in BRCA1 mutation carriers was detected by mammography alone, compared with seven (three invasive) of 11 screen-detected cancers in BRCA2 (P < 0.0001). In the model, the preclinical period during which cancer is screen-detectable was 1 to 4 years for BRCA1 and 2 to 7 years for BRCA2. The model predicted breast cancer mortality reductions of 42% to 47% for mammography, 48% to 61% for MRI, and 50% to 62% for combined screening.Conclusions: Our studies suggest substantial mortality benefits in using MRI to screen BRCA1/2 mutation carriers aged 25 to 60 years but show important clinical differences in natural history.Impact: BRCA1 and BRCA2 mutation carriers may benefit from different screening protocols, for example, below the age of 40. Cancer Epidemiol Biomarkers Prev; 21(9); 1458-68. Ó2012 AACR.

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“…The average number of specimens per lesion obtained using VACB was 12 (range [8][9][10][11][12][13][14][15][16][17][18][19][20]. Specimen radiography was performed for all lesions characterised by calcifications.…”

Section: Methodsmentioning

confidence: 99%

“…Based on data obtained from literature, an analytical approach suggested that core biopsy and open-breast biopsy might be clinically equivalent, with core biopsy being less costly than open breast biopsy [16,17].…”

Section: Introductionmentioning

confidence: 99%

Management of Nonpalpable Breast Lesions in a Modern Functional Breast Unit

Altomare

Guerriero

Giacomelli

et al. 2005

Breast Cancer Res Treat

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During the last 20 years an ever increasing number of nonpalpable breast lesions (NPBL) have been identified. A cytohistological definition is required to establish the correct diagnostic classification of these lesions and the suitable therapy to be used. The Fine-Needle Aspiration Cytology (FNAC), the Advanced Breast Biopsy Instrumentation (ABBI) system or the Vacuum Assisted Core Biopsy (VACB) represent valid alternatives to the surgical excision with needle localisation. 591 NPBL have been included in the present study. The suspected grade of each lesion was then assigned according to the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. All the BI-RADS 4 and 5, and all the BI-RADS 3 lesions, which after 6-month follow-up showed altered morphology, were sampled for cytological and/or histological examinations by FNAC, VACB or biopsy by ABBI system. The diagnostic algorithm used in this study obviated a surgical procedure in 574 women (97.1%), yielding a 73.9% decrease in the cost of diagnosis compared with surgical biopsy, and a 48.1% decrease in cost if all lesions had been histologically tested using ABBI or VACB procedure. Compared to surgical biopsy, VACB and ABBI system are less expensive, and have smaller emotional and aesthetical impact on patients; however they retain the same sensitivity and specificity.

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Cost-effectiveness of stereotactic large-core needle biopsy for nonpalpable breast lesions compared to open-breast biopsy

Cited by 32 publications

References 20 publications

Cost-effectiveness of different reading and referral strategies in mammography screening in the Netherlands

Cost-effectiveness of different reading and referral strategies in mammography screening in the Netherlands

Differences in Natural History between Breast Cancers in BRCA1 and BRCA2 Mutation Carriers and Effects of MRI Screening-MRISC, MARIBS, and Canadian Studies Combined

Management of Nonpalpable Breast Lesions in a Modern Functional Breast Unit

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