Cost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcifications
Abstract 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-te...
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SpringerOpen
2025-06-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-025-01990-y |
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| author | Barbara J. Fueger Fabian Tollens Clemens G. N. Kaiser Thomas H. Helbich Nina Pötsch Paola Clauser Pascal A. T. Baltzer |
| author_facet | Barbara J. Fueger Fabian Tollens Clemens G. N. Kaiser Thomas H. Helbich Nina Pötsch Paola Clauser Pascal A. T. Baltzer |
| author_sort | Barbara J. Fueger |
| collection | DOAJ |
| description | Abstract 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 |
| format | Article |
| id | doaj-art-dd6fa5480d4e468e9122a003a7e378a3 |
| institution | Kabale University |
| issn | 1869-4101 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj-art-dd6fa5480d4e468e9122a003a7e378a32025-08-20T03:45:11ZengSpringerOpenInsights into Imaging1869-41012025-06-0116111010.1186/s13244-025-01990-yCost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcificationsBarbara J. Fueger0Fabian Tollens1Clemens G. N. Kaiser2Thomas H. Helbich3Nina Pötsch4Paola Clauser5Pascal A. T. Baltzer6Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General HospitalDepartment of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of HeidelbergDepartment of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of HeidelbergDivision of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General HospitalDivision of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General HospitalDivision of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General HospitalDivision of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General HospitalAbstract 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 Abstracthttps://doi.org/10.1186/s13244-025-01990-yBreast cancerScreeningBiopsyShared decision makingCost-effectiveness analysis |
| spellingShingle | Barbara J. Fueger Fabian Tollens Clemens G. N. Kaiser Thomas H. Helbich Nina Pötsch Paola Clauser Pascal A. T. Baltzer Cost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcifications Insights into Imaging Breast cancer Screening Biopsy Shared decision making Cost-effectiveness analysis |
| title | Cost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcifications |
| title_full | Cost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcifications |
| title_fullStr | Cost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcifications |
| title_full_unstemmed | Cost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcifications |
| title_short | Cost-effectiveness of contrast-enhanced breast MRI in suspicious mammographic microcalcifications |
| title_sort | cost effectiveness of contrast enhanced breast mri in suspicious mammographic microcalcifications |
| topic | Breast cancer Screening Biopsy Shared decision making Cost-effectiveness analysis |
| url | https://doi.org/10.1186/s13244-025-01990-y |
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