Routine ultrasounds for women with dense breasts may not be cost-effective

A computer-based simulation demonstrated that routine ultrasounds for patients with dense breasts may not be worth the costs of supplemental examination.

Routine ultrasounds for women with dense breasts may not be cost-effective
Routine ultrasounds for women with dense breasts may not be cost-effective

HealthDay News -- The value of ultrasound screening for female patients with dense breasts who've had a normal mammogram is being reconsidered, according to the results of a study published in the Annals of Internal Medicine.

“Many states have laws requiring mammography facilities to tell women with dense breasts and a negative screening mammography result to discuss supplemental screening tests with their providers,” noted Brian Sprague, PhD, assistant professor of surgery at the University of Vermont in Burlington, and colleagues.

“The most readily available supplemental screening method is ultrasonography, but little is known about its effectiveness,” added the investigators.

To evaluate the benefits, harms, and cost-effectiveness of supplemental ultrasonography screening for women with dense breasts, the researchers used a computer-based simulation model to examine three scenarios.

In the first scenario, women received routine mammograms only. In the second, women with a category 4 breast density received a mammogram and an ultrasound. In the third scenario, categories 3 and 4 were grouped together.

Using information from breast cancer surveillance databases, the scientists looked at how many breast cancer deaths could likely be prevented by adding ultrasound and how many biopsies would occur after a false-positive ultrasound.

Performing supplemental ultrasound after normal mammograms on 10,000 female patients with dense breasts, aged 50 to 74 years, would prevent about four breast cancer deaths a year, concluded the researchers.

“Supplemental ultrasonography screening for women with dense breasts would substantially increase costs while producing relatively small benefits,” concluded the study authors.

References

  1. Sprague B et al. Ann Intern Med. 2014; doi: 10.7326/M14-0692
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