title: Screening for breast cancer with Breast-CT in a ProHTA simulation.
abstract: OBJECTIVE
  The potential of dedicated Breast-CT is evaluated by simulating its impact onto the performance of the German breast cancer screening program. Attendance rates, cancer detection and economic implications are quantified.
  
  
  METHODS
  Based on a prospective health technology assessment approach, we simulated screening in different scenarios.
  
  
  RESULTS
  In the simulation, attendance rates increase from 54 to up to 72% due to reduced pain. Breast cancers will be detected earlier while nodal positives and distant recurrences decrease. Assuming no additional cost, cost savings of up to €55 million in one screening period are computed.
  
  
  CONCLUSIONS
  The simulation indicates that earlier cancer detection, fewer unnecessary biopsies and less pain are potential benefits of Breast-CT resulting in cost savings and higher attendance.
authors.affiliation: Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany.|National Leading-Edge Cluster Medical Technologies 'Medical Valley EMN', Erlangen, Bavaria, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Ruile
authors.affiliation: Chair for Computer Networks & Communication Systems (Computer Science 7), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany.
authors.forename: Anatoli
authors.initials: A
authors.lastname: Djanatliev
authors.affiliation: National Leading-Edge Cluster Medical Technologies 'Medical Valley EMN', Erlangen, Bavaria, Germany.|Interdisciplinary Centre for Health Technology Assessment (HTA) & Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Kriza
authors.affiliation: Department of Health Management, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Bavaria, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Meier
authors.affiliation: Chair of Medical Informatics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany.
authors.forename: Ines
authors.initials: I
authors.lastname: Leb
authors.affiliation: Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany.|National Leading-Edge Cluster Medical Technologies 'Medical Valley EMN', Erlangen, Bavaria, Germany.
authors.forename: Willi A
authors.initials: WA
authors.lastname: Kalender
authors.affiliation: National Leading-Edge Cluster Medical Technologies 'Medical Valley EMN', Erlangen, Bavaria, Germany.|Interdisciplinary Centre for Health Technology Assessment (HTA) & Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Kolominsky-Rabas
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000295:instrumentation*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013673:Technology Assessment, Biomedical; D014057:Tomography, X-Ray Computed / Q000592:standards*
keywords: breast cancer; computed tomography; health economics; health technology assessment; mammography screening; simulation