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3-D mammography bests digital screenings in costs, diagnosis

While 3-D mammography screening are FDA-approved, only about half of the NCI's Breast Cancer Surveillance Consortium participants offer the service.

Jeff Lagasse, Associate Editor

Credit: <a href="https://www.brhc.org/sites/www/Uploads/3D%20vs%202D%20mammo.jpg">Bothwell Regional Health Center</a>.Credit: Bothwell Regional Health Center.

Hospitals or radiology speciality groups considering an investment in 3-D mammography technology might have just gotten another reason to take that step.

University of Pennsylvania Perelman School of Medicine researchers discussed preliminary findings this week during the 2017 San Antonio Breast Cancer Symposium that showed 3-D mammography actually reduced costs, even though screenings are more expensive.

[Also: Mammogram reimbursement would work best as bundled payments, researchers say in the Journal of the American College of Radiology]

The Penn Medicine researchers analyzed 46,483 screening episodes -- a single screening mammogram and all subsequent breast diagnosis related costs for the following year -- in two hospitals within its health system in 2012 and 2013.

"Breast imaging is more precise than ever thanks to DBT," said Emily Conant, MD, chief of Breast Imaging at Penn Medicine, in a statement. DBT, or digital breast tomosynthesis, is 3-D.  "If you look at expenses associated with breast diagnosis in the following year after initial screening, DBT is more cost effective in terms of health system or population level screening."

Previous studies modeling outcomes have demonstrated that DBT can be cost effective. In this new study, the authors analyzed actual costs and patient outcomes within a single health system where both DM and DBT screening occurred. They excluded any episodes in which the patient had a prior breast cancer diagnosis or reached 90 years of age before the end of the follow-up period.

Compared to DM episodes, DBT episodes had lower false positive rates, at 8.6 percent vs. 10.8 percent, and higher true negatives, 90.9 percent as opposed to 88.7 percent. There were no statistically significant differences between DBT and DM episodes with respect to true positive and false negative rates.

While 3-D mammography screening are FDA-approved, only about half of the National Cancer Institute's Breast Cancer Surveillance Consortium participants offer the service. Prior studies have determined that 3-D screenings detect more cancers and do so earlier, including a 2016 article in the Journal of the American Medical Association, for which Penn's Conant was listed as an author.

The results Penn Medicine presented this week suggest that 3-D screening is better for patients and costs hospitals and specialists less in the long run, the academic medical center said.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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