Cost-effectiveness of screening with contrast enhanced magnetic resonance imaging vs X-ray mammography of women at a high familial risk of breast cancer.
Cost-effectiveness of screening with contrast enhanced magnetic resonance imaging vs X-ray mammography of women at a high familial risk of breast cancer.
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DOI：
10.1038/sj.bjc.6603356
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发表时间：
2006-10-09
影响因子：
8.8
通讯作者：
Leach, M. O.
中科院分区：
文献类型：
--
作者：
Griebsch, I.;Brown, J.;Boggis, C.;Dixon, A.;Dixon, M.;Easton, D.;Eeles, R.;Evans, D. G.;Gilbert, F. J.;Hawnaur, J.;Kessar, P.;Lakhani, S. R.;Moss, S. M.;Nerurkar, A.;Padhani, A. R.;Pointon, L. J.;Potterton, J.;Thompson, D.;Turnbull, L. W.;Walker, L. G.;Warren, R.;Leach, M. O.
对比增强磁共振成像（CE MRI）是筛查乳腺癌高家族风险女性的最敏感工具。本研究的目的是评估X射线乳腺摄影（XRM）、CE MRI或两者联合使用的成本效益。总共有649名女性入组MARIBS研究，并接受CE MRI和乳腺X射线摄影筛查，共进行了1881次筛查和1-7次单独的年度筛查事件。从22个中心招募了35-49岁的乳腺癌高风险女性，因为她们有很强的乳腺癌家族史，或者是BRCA 1，BRCA 2或TP 53突变的检测携带者，或者有50%的遗传这种突变的风险，并提供每年MRI和XRM 2至7年。收集了关于进一步调查的数量和类型的信息，并使用具体计算的单位成本来计算每发现一种癌症的增量成本。乳腺X线摄影检测到的癌症数量为13例，CE MRI检测到的癌症数量为27例，乳腺X线摄影和CE MRI联合检测到的癌症数量为33例。在BRCA 1（BRCA 2）突变携带者或与BRCA 1（BRCA 2）突变有一级亲属的女性亚组中，相应的数字分别为3（6），12（7）和12（11）。对于所有女性来说，与乳腺X光检查相比，CE MRI和乳腺X光检查检测到的每种癌症的增量成本为28284英镑。当仅考虑BRCA 1或BRCA 2组时，该成本将降低至11731英镑（CE MRI与乳房X线摄影）和15302英镑（CE MRI和乳房X线摄影与乳房X线摄影）。结果是最敏感的CE MRI筛查试验的单位成本估计。对比增强MRI可能是高风险女性的一种具有成本效益的筛查方式，特别是对于BRCA 1和BRCA 2亚组。需要进一步的工作来评估筛查对死亡率和健康相关生活质量的影响。
Contrast enhanced magnetic resonance imaging (CE MRI) is the most sensitive tool for screening women who are at high familial risk of breast cancer. Our aim in this study was to assess the cost-effectiveness of X-ray mammography (XRM), CE MRI or both strategies combined. In total, 649 women were enrolled in the MARIBS study and screened with both CE MRI and mammography resulting in 1881 screens and 1–7 individual annual screening events. Women aged 35–49 years at high risk of breast cancer, either because they have a strong family history of breast cancer or are tested carriers of a BRCA1, BRCA2 or TP53 mutation or are at a 50% risk of having inherited such a mutation, were recruited from 22 centres and offered annual MRI and XRM for between 2 and 7 years. Information on the number and type of further investigations was collected and specifically calculated unit costs were used to calculate the incremental cost per cancer detected. The numbers of cancer detected was 13 for mammography, 27 for CE MRI and 33 for mammography and CE MRI combined. In the subgroup of BRCA1 (BRCA2) mutation carriers or of women having a first degree relative with a mutation in BRCA1 (BRCA2) corresponding numbers were 3 (6), 12 (7) and 12 (11), respectively. For all women, the incremental cost per cancer detected with CE MRI and mammography combined was £28 284 compared to mammography. When only BRCA1 or the BRCA2 groups were considered, this cost would be reduced to £11 731 (CE MRI vs mammography) and £15 302 (CE MRI and mammography vs mammography). Results were most sensitive to the unit cost estimate for a CE MRI screening test. Contrast-enhanced MRI might be a cost-effective screening modality for women at high risk, particularly for the BRCA1 and BRCA2 subgroups. Further work is needed to assess the impact of screening on mortality and health-related quality of life.
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影响因子：
158.5
作者：
Kriege, M;Brekelmans, CTM;Klijn, JGM
通讯作者：
Klijn, JGM
影响因子：
--
作者：
Johnston, K;Brown, J
通讯作者：
Brown, J
影响因子：
6.3
作者：
BRYAN, S;BROWN, J;WARREN, R
通讯作者：
WARREN, R
影响因子：
5.9
作者：
Plevritis, SK
通讯作者：
Plevritis, SK
影响因子：
--
作者：
WALD, NJ;MURPHY, P;FROST, C
通讯作者：
FROST, C