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Cost effectiveness of digital breast tomosynthesis for breast cancer screening in a Swedish setting

Fridhammar, Adam ; Johnson, Kristin LU orcid ; Rosso, Aldana LU orcid ; Andersson, Emelie ; Andersson, Ingvar LU ; Lång, Kristina LU ; Borgquist, Signe LU ; Carlsson, Katarina Steen LU orcid and Zackrisson, Sophia LU (2025) In European Journal of Radiology 187.
Abstract

Background: In the Malmö Breast Tomosynthesis Screening Trial (MBTST), digital breast tomosynthesis (DBT) increased the detection rate of breast cancer compared to currently used digital mammography (DM). This study evaluated the cost effectiveness of DBT versus DM in Sweden using data from MBTST. Materials and method: A health economic model was used to compare a breast cancer screening programme using DBT to breast cancer screening using DM in women aged 40–74. Model input values on demographics, breast cancer incidence and mortality were derived from regional registries. The effect of DBT on detection rates and interval breast cancer was based on MBTST. Key information is not yet available and scenario analyses were used to explore... (More)

Background: In the Malmö Breast Tomosynthesis Screening Trial (MBTST), digital breast tomosynthesis (DBT) increased the detection rate of breast cancer compared to currently used digital mammography (DM). This study evaluated the cost effectiveness of DBT versus DM in Sweden using data from MBTST. Materials and method: A health economic model was used to compare a breast cancer screening programme using DBT to breast cancer screening using DM in women aged 40–74. Model input values on demographics, breast cancer incidence and mortality were derived from regional registries. The effect of DBT on detection rates and interval breast cancer was based on MBTST. Key information is not yet available and scenario analyses were used to explore the reduction in relative breast cancer mortality required to meet willingness-to-pay thresholds between €10,000 and €50,000/quality-adjusted life year (QALY), assuming three levels of DBT examination cost. Results: Compared with DM, DBT-screening was estimated to detect 56 more invasive cancers and 18 fewer interval cancers per 100,000 invited women. The relative reduction in breast cancer mortality for DBT to be cost effective varied between 2.3 and 14.2% for the lowest versus highest evaluated cost and willingness-to-pay scenarios. The required reduction at a DBT cost and willingness-to-pay threshold of €61 and €50,000/QALY respectively was 3.6%. Conclusion: This model analysis shows that the cost effectiveness of DBT-screening is dependent on the expected relative reduction in breast cancer mortality and the willingness-to-pay for screening. Furthermore, the results are driven by the future costs for DBT-screening examinations.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast cancer, Cost effectiveness, Digital breast tomosynthesis, Sweden
in
European Journal of Radiology
volume
187
article number
112088
publisher
Elsevier
external identifiers
  • pmid:40273760
  • scopus:105003097925
ISSN
0720-048X
DOI
10.1016/j.ejrad.2025.112088
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s)
id
437a1bcb-07e9-4801-8035-dd6c57f4787f
date added to LUP
2025-06-03 10:32:12
date last changed
2025-07-01 13:31:49
@article{437a1bcb-07e9-4801-8035-dd6c57f4787f,
  abstract     = {{<p>Background: In the Malmö Breast Tomosynthesis Screening Trial (MBTST), digital breast tomosynthesis (DBT) increased the detection rate of breast cancer compared to currently used digital mammography (DM). This study evaluated the cost effectiveness of DBT versus DM in Sweden using data from MBTST. Materials and method: A health economic model was used to compare a breast cancer screening programme using DBT to breast cancer screening using DM in women aged 40–74. Model input values on demographics, breast cancer incidence and mortality were derived from regional registries. The effect of DBT on detection rates and interval breast cancer was based on MBTST. Key information is not yet available and scenario analyses were used to explore the reduction in relative breast cancer mortality required to meet willingness-to-pay thresholds between €10,000 and €50,000/quality-adjusted life year (QALY), assuming three levels of DBT examination cost. Results: Compared with DM, DBT-screening was estimated to detect 56 more invasive cancers and 18 fewer interval cancers per 100,000 invited women. The relative reduction in breast cancer mortality for DBT to be cost effective varied between 2.3 and 14.2% for the lowest versus highest evaluated cost and willingness-to-pay scenarios. The required reduction at a DBT cost and willingness-to-pay threshold of €61 and €50,000/QALY respectively was 3.6%. Conclusion: This model analysis shows that the cost effectiveness of DBT-screening is dependent on the expected relative reduction in breast cancer mortality and the willingness-to-pay for screening. Furthermore, the results are driven by the future costs for DBT-screening examinations.</p>}},
  author       = {{Fridhammar, Adam and Johnson, Kristin and Rosso, Aldana and Andersson, Emelie and Andersson, Ingvar and Lång, Kristina and Borgquist, Signe and Carlsson, Katarina Steen and Zackrisson, Sophia}},
  issn         = {{0720-048X}},
  keywords     = {{Breast cancer; Cost effectiveness; Digital breast tomosynthesis; Sweden}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Radiology}},
  title        = {{Cost effectiveness of digital breast tomosynthesis for breast cancer screening in a Swedish setting}},
  url          = {{http://dx.doi.org/10.1016/j.ejrad.2025.112088}},
  doi          = {{10.1016/j.ejrad.2025.112088}},
  volume       = {{187}},
  year         = {{2025}},
}