MRI Breast Cancer Screening Seen Cost-Effective for Those at Familial Risk

I wanted to share with our female readers in case they hadn’t read this article.

By Joe Elia

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

NEJM Journal Watch

MRI-based breast screening appears cost-effective in women at increased familial risk between ages 35 and 60, according to an economic modeling study in JAMA Oncology.

Analysts used data from an earlier trial (FaMRIsc) to model results in a cohort of 10 million Dutch women at increased familial risk (20% or more) for breast cancer who don’t harbor BRCA1/2 or TP53 genetic variants.

They found that despite its higher costs and false-positive findings, MRI screening every 18 months between ages 35 and 60 found more early-stage tumors (leading to fewer being found at a late stage) and resulted in lower mortality than a system relying on mammography. Annual MRI screening was even better, but that strategy exceeded U.K. thresholds for cost-effectiveness — roughly $25,000 per quality-adjusted life year gained.

Alternating annual MRI with mammography gave similar results, but at slightly above acceptable cost thresholds.