AUTHOR=Li Jiaxin , Jia Ziqi , Zhang Menglu , Liu Gang , Xing Zeyu , Wang Xin , Huang Xin , Feng Kexin , Wu Jiang , Wang Wenyan , Wang Jie , Liu Jiaqi , Wang Xiang
TITLE=Cost-Effectiveness Analysis of Imaging Modalities for Breast Cancer Surveillance Among BRCA1/2 Mutation Carriers: A Systematic Review
JOURNAL=Frontiers in Oncology
VOLUME=11
YEAR=2022
URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.763161
DOI=10.3389/fonc.2021.763161
ISSN=2234-943X
ABSTRACT=BackgroundBRCA1/2 mutation carriers are suggested with regular breast cancer surveillance screening strategies using mammography with supplementary MRI as an adjunct tool in Western countries. From a cost-effectiveness perspective, however, the benefits of screening modalities remain controversial among different mutated genes and screening schedules.
MethodsWe searched the MEDLINE/PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases to collect and compare the results of different cost-effectiveness analyses. A simulated model was used to predict the impact of screening strategies in the target group on cost, life-year gained, quality-adjusted life years, and incremental cost-effectiveness ratio (ICER).
ResultsNine cost-effectiveness studies were included. Combined mammography and MRI strategy is cost-effective in BRCA1 mutation carriers for the middle-aged group (age 35 to 54). BRCA2 mutation carriers are less likely to benefit from adjunct MRI screening, which implies that mammography alone would be sufficient from a cost-effectiveness perspective, regardless of dense breast cancer.
ConclusionsPrecision screening strategies among BRCA1/2 mutation carriers should be conducted according to the acceptable ICER, i.e., a combination of mammography and MRI for BRCA1 mutation carriers and mammography alone for BRCA2 mutation carriers.
Systematic Review RegistrationPROSPERO, identifier CRD42020205471.