Comprehensive Evaluation of the Effectiveness and Cost of Different Imaging Protocols in Breast Cancer Screening

doi:10.7517/issn.1674-0475.231007

Abstract

Abstract: The single or combined diagnostic efficacy of ultrasound, mammography and magnetic resonance imaging in dense breast was evaluated in combination with medical economics. Data from 130 patients with 134 lesions of dense breast who underwent surgery or needle biopsy were retrospectively analyzed, and all patients completed ultrasound, mammography and magnetic resonance examination within 2 weeks before surgery. The results showed that mammography in a single examination protocol was of limited value in the diagnosis of dense breast lesions. Magnetic resonance imaging had high sensitivity and specificity, but the cost-effectiveness ratio was high (4.84), making it unsuitable for general screening. Ultrasound had high sensitivity and the lowest cost-effectiveness ratio (0.99), which could be used as the preferred examination, but had insufficient specificity, so supplementary examination was needed to improve the diagnostic effect. The combination of ultrasound and magnetic resonance had the highest accuracy and the lowest incremental cost-effectiveness ratio, making it the optimal solution from a medical economics perspective. Dense breast ultrasound has found suspicious lesions, and then combined with magnetic resonance examination, can significantly improve the diagnostic efficiency.

Key words: dense breast, ultrasound, mammography, magnetic resonance imaging, medical economics, effect evaluation

MA Cai, WANG Yongsheng, CHEN Wenjing. Comprehensive Evaluation of the Effectiveness and Cost of Different Imaging Protocols in Breast Cancer Screening[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2024, 42(1): 53-57.

References

[1] 黄育北,佟仲生,陈可欣,等.《中国女性乳腺癌筛查指南》解读(精简版)[J].中国肿瘤临床, 2019, 46(9):433-441.
[2] Sung H, Ferlay J, Siegel R L, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA:A Cancer Journal for Clinicians, 2021, 71(3):209-249.
[3] Mukama T, Kharazmi E, Xu X, et al. Risk-adapted starting age of screening for relatives of patients with breast cancer[J]. JAMA Oncology, 2020, 6(1):68-74.
[4] 丁苇,吴绍腾,赖晓全,等.钼靶、超声及MRI对乳腺疾病的诊断价值对比研究[J].中国CT和MRI杂志, 2022, 20(2):81-83.
[5] 李晓虹,胡秋根,杨少民,等. MRI筛查乳腺癌的简化序列探讨[J].实用放射学杂志, 2021, 37(5):768-771.
[6] 阳君,赵欣,苏丹柯,等.钼靶和超声及MRI对乳腺癌的诊断价值多中心研究及卫生经济学评价[J].放射学实践, 2018, 33(6):579-581.
[7] González-Huebra I, Elizalde A, García-Baizán A, et al. Is it worth to perform preoperative MRI for breast cancer after mammography, tomosynthesis and ultrasound?[J]. Magnetic Resonance Imaging, 2019, 57(4):317-322.
[8] Magny S J, Shikhman R, Keppke A L. Breast Imaging Reporting and Data System[M]. Treasure Island (FL):StatPearls Publishing LLC, 2022.
[9] 楚天舒,韩雅慧,张晨曦,等.长三角地区医疗服务项目价格结构比较研究[J].中国卫生经济, 2023, 42(1):57-61.
[10] 张毓,苏丹柯,张连连,等.锥光束乳腺CT、钼靶、超声及MRI对乳腺病变的诊断价值及卫生经济学评价[J].实用放射学杂志, 2023, 39(1):53-56.
[11] Brougham M, Schlander M, Telser H, et al.Use of the incremental cost-effectiveness ratio for decision-making policies-What is the problem?A perspective paper[J]. Expert Review of Pharmacoeconomics&Outcomes Research, 2022, 22(6):913-918.
[12] 胡晓龙,吴堡,赵燕,等. MRI、数字钼靶X线及超声对乳腺良、恶性病变的诊断价值对比[J].中国CT和MRI杂志, 2021, 19(5):40-42.
[13] 李彦娟,张祥,冯京华,等.超声与磁共振诊断乳腺癌的临床价值比较[J].中国超声医学杂志, 2020, 36(10):891-894.
[14] 叶萍,彭格红,周炜炜,等.多模态超声与磁共振在乳腺癌中的诊断价值[J].医学研究杂志, 2022, 51(4):140-143.
[15] 来炳岩,樊健敏.动态增强MRI、超声与钼靶对乳腺良、恶性病灶的诊断价值对比[J].中国CT和MRI杂志, 2021, 19(9):83-85.
[16] Harvey S C, Di Carlo P A, Lee B, et al.An abbreviated protocol for high-risk screening breast MRI saves time and resources[J]. Journal of the American College of Radiology, 2016, 13(11S):R74-R80.
[17] 宋静,吉雅玲. DIP改革新形势下医院医保精细化管理探讨[J].中国卫生经济, 2022, 41(2):77-79.