Journal article
Surveillance Mammography After Breast Conservation Therapy: Is Tomosynthesis Worth It?
American journal of clinical oncology, v 42(8), pp 682-686
Aug 2019
PMID: 31313678
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
We investigated the downstream workup and costs associated with digital breast tomosynthesis (DBT) compared with 2-dimensional full field digital mammogram (FFDM) when employed as initial follow-up imaging in breast conservation therapy.
Between the years 2015 and 2017, 450 consecutive breast conservation therapy patients, ages 32 to 89, with a follow-up DBT (n=162) or FFDM (n=288) were retrospectively reviewed. The primary endpoints were further workup after follow-up mammogram and associated health care costs at 1 year. A single DBT costs an estimated $149 compared with $111 for FFDM, based on Centers for Medicare claims data from the Oncology Care Model.
The first posttreatment mammogram was received within 3 (20%), 3 to 6 (32%), or after 6 months (48%) following radiation. Younger patients and those undergoing hypofractionated radiation were more likely to get DBT. There were no differences in stage, receptor status, or mammogram timing between those in the FFDM and DBT groups.The following downstream workup ensued for DBT compared with FFDM imaging: 18% versus 29% short-interval (6-mo) mammogram (odds ratio=1.83, P=0.01), 6% versus 11% breast magnetic resonance imaging (odds ratio=1.90, P=0.08), 4% ultrasound for each, and 3% biopsy for each (1 positive in the FFDM group). Including downstream workup, the estimated cost per patient in the DBT group was $216.14 compared with $237.83 in the FFDM group. Independent predictors for reduced downstream workup per multivariable analysis were the use of DBT and first follow-up mammogram at least 6 months after radiation (P<0.05).
Excess workup was reduced with DBT compared with FFDM in the posttreatment setting, which translated to an improvement in cost efficiency in this study.
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Details
- Title
- Surveillance Mammography After Breast Conservation Therapy: Is Tomosynthesis Worth It?
- Creators
- Shaakir Hasan - Allegheny Health NetworkSteven Gresswell - Radiation Oncology AssociatesBrittany Colosimo - Lake Erie College of Osteopathic MedicineKevin Weinberger - Lake Erie College of Osteopathic MedicineSidney Anderson - Radiation Oncology AssociatesStephen Abel - Allegheny Health NetworkMatthew Bigbee - Radiation Oncology AssociatesBetty Shindel - Allegheny Health NetworkChristie Hilton - Drexel University, General Internal MedicineThomas Julian - Allegheny General HospitalMark Trombetta - Allegheny Health Network
- Publication Details
- American journal of clinical oncology, v 42(8), pp 682-686
- Publisher
- Lippincott
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000479104800010
- Scopus ID
- 2-s2.0-85070478822
- Other Identifier
- 991021860703204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology