Cost-effectiveness of Biennial Breast Screening in Women With Dense Breasts: Exploratory Analysis of Pathways Incorporating an Emerging Blood RNA Test.

BACKGROUND

Emerging blood-based tests have potential to complement current breast imaging to increase early-stage detection for women with dense breasts. This analysis examines the cost-effectiveness of potential pathways using preliminary data from an emerging blood test to inform future research.

MATERIALS AND

METHODS

Preliminary accuracy results for the blood test were modeled in combination, and in comparison, with mammography for biennial screening starting at age 40 for women with dense breasts using a lifetime Markov model. Costs, life years (LYs) and quality-adjusted life-years (QALYs) of each screening pathway were compared. The primary results were probabilistic incremental cost-effectiveness ratios (ICER).

RESULTS

Modeling showed the blood test generating 22.40 LYs, 18.78 QALYs per individual, and lifetime costs of $21,642. Combination of blood test and mammography produced higher LYs, QALYs, and costs comparatively (22.42 LYs, 18.80 QALYs, $24,986), resulting in an ICER of $169,384 per QALY compared to blood test alone. Two-way sensitivity analysis showed positive net monetary value for a range of blood test sensitivities and specificities.

CONCLUSIONS

The blood test may represent a cost-effective option relative to mammography alone or in combination for biennial screening of women with dense breasts, supporting the rationale for continued evidence generation.