[Analysis of Cost-effectiveness of screening for breast cancer with conventional mammography, digital and magnetic resonance imaging].
A cost-effectiveness analysis was conducted in screening for breast cancer. The use of conventional mammography, digital and magnetic resonance imaging were compared with natural disease history as a baseline. A Markov model projected breast cancer in a group of 100,000 women for a 30 year period, with screening every two years. Four distinct scenarios were modeled: (1) the natural history of breast cancer, as a baseline, (2) conventional film mammography, (3) digital mammography and (4) magnetic resonance imaging. The costs of the scenarios modeled ranged from R$ 194.216,68 for natural history, to R$ 48.614.338,31, for screening with magnetic resonance imaging. The difference in effectiveness between the interventions ranged from 300 to 78.000 years of life gained in the cohort. The ratio of incremental cost-effectiveness in terms of cost per life-year gains, conventional mammographic screening has produced an extra year for R$ 13.573,07. The ICER of magnetic resonance imaging was R$ 2.904.328,88, compared to no screening. In conclusion, it is more cost-effective to perform the screening with conventional mammography than other technological interventions.
Laboratório de Ciências Radiológicas, Universidade do Estado do Rio de Janeiro, Maracanã, Rio de Janeiro 20550-900. antoniop@uerj.br
Antonio Augusto de Freitas
AA
Peregrino
Cid Manso de Mello
CM
Vianna
Carlos Eduardo Veloso
CE
de Almeida
Gabriela Bittencourt
GB
Gonzáles
Samara Cristina Ferreira
SC
Machado
Frances Valéria
FV
Costa e Silva
Marcus Paulo da Silva
MP
Rodrigues
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics*; D008327:Mammography / Q000191:economics*; D011856:Radiographic Image Enhancement / Q000191:economics*