Abbreviated breast MRI deemed an attractive screening option—sometimes
Abbreviated breast MRI is a cost-effective means of screening women with dense breast tissue for breast cancer—as long as the per-exam costs don’t top 82% of what would have been spent to perform full-protocol breast MRI.
Researchers in Germany made the finding after analyzing recently published data on abbreviated breast MRI (AB-MRI) alongside similar data on digital breast tomosynthesis and standard mammography, as well as full breast protocol MRI (FB-MRI).
The data originated in prospective, multicenter screening trials. To quantify the relative costs and benefits of the various modalities, the team modeled the economic effects of biennial screening based on quality-adjusted life years (QALYs) from the perspective of the U.S. healthcare system.
Corresponding author Clemens Kaiser, MD, of Heidelberg University in Germany and colleagues describe their work in a paper published open-access April 28 in European Radiology.
“At an assumed cost per examination of $263 for AB-MRI (84% of the cost of a FB-MRI examination), the discounted cumulative costs of both MR-based strategies accounted comparably,” Kaiser and co-authors report.
More:
Reducing the costs of AB-MRI below $259 (82% of the cost of a FB-MRI examination, respectively), the incremental cost-effectiveness ratio of FB-MRI exceeded the willingness-to-pay threshold and the AB-MRI-strategy should be considered preferable in terms of cost-effectiveness.”
The recommendation comes with qualifiers, Kaiser and colleagues point out. These include lower specificity scores for AB-MRI versus FB-MRI—a concession likely to increase false positives and, with them, recall rates.
Further, the quicker protocol’s appropriateness may decline as technical advances in FB-MRI “allow for shorter examination times without possible detriments to diagnostic performance.”
In fact, Kaiser and co-authors postulate, “the gap between abbreviated protocols and full protocols may diminish to some extent in the future. Based on these developments, we deem recommendations on the role of AB-MRI in screening women with dense breasts premature as of today.”
In a patient-friendly fact sheet, a provider organization offering AB-MRI, Florida-based Moffitt Cancer Center, notes the exam is not currently covered by insurance companies in that state and costs patients $500.
More coverage of abbreviated MRI:
Patients prioritize higher imaging sensitivity over lower costs when weighing HCC screening options
Follow-up imaging for incidental liver lesions on breast MRI rarely necessary
Fast MRI an ‘effective and feasible’ option for detecting cancer in dense breasts
Reference:
Tollens and Kaiser, et al., “Economic potential of abbreviated breast MRI for screening women with dense breast tissue for breast cancer.” European Radiology, April 28, 2022. DOI: doi.org/10.1007/s00330-022-08777-5