Researchers at The Dartmouth Institute
are evaluating the benefits, harms, and cost-effectiveness of supplemental screening.
More than half of the states in the United States have passed laws requiring that women be notified if they have mammographically dense breast tissue. While laws vary from state to state, they typically involve mailings suggesting that such women may benefit from screening beyond mammography. Researchers at The Dartmouth Institute are evaluating the benefits, harms, and cost-effectiveness of supplemental screening among women with dense breasts. The screening procedures we are considering are breast ultrasonography and digital breast tomosynthesis (also known as 3-D mammography). Ongoing work is addressing breast cancer screening outcomes within the Breast Cancer Surveillance Consortium.
To evaluate breast ultrasound, researchers at The Dartmouth Institute undertook collaborative modeling with three Cancer Intervention and Surveillance Modelling Network (CISNET) breast cancer simulation modeling groups. We estimated the screening outcomes for mammography screening alone compared with mammography screening followed by breast ultrasonography, which is a diagnostic imaging technique utilizing reflected high-frequency sound waves. We found that supplemental ultrasonography would greatly increase costs with relatively small health benefits. In contrast, in another simulation study of supplemental 3-D mammography screening, we identified parameters under which 3-D mammography screening would have the potential to provide health benefits without a substantial increase in costs. Thus, while further study is needed for 3-D mammography, supplemental ultrasonography screening is of limited value.
David Aman, Kristen Anton, Roberta DiFlorio, Tracy Frazee, Martha Goodrich, Julie Weiss
Oguzhan Alagoz, Diana Buist, Mucahit Cevik, Harry DeKoning, Jennifer Haas, Louise Henderson, Karla Kerlikowske, Christoph Lee, Constance Lehman, Jeanne Mandelblatt, Diana Miglioretti, Clyde Schechter, Brian Sprague, Natasha Stout, Amy Trentham-Dietz, Jeroen van den Broek, Nicolein vanRavestyn
For more information on breast cancer screening,
contact Anna Tosteson