Costs of Diagnostic and Preoperative Workup with and without Breast MRI in Older Women with a Breast Cancer Diagnosis

Costs of Diagnostic and Preoperative Workup with and without Breast MRI in Older Women with a Breast Cancer Diagnosis

Abstract

OBJECTIVE:

Breast cancer in the U.S. – estimated at 232,670 incident cases in 2014 – has the highest aggregate economic burden of care relative to other female cancers. Yet, the amount of cost attributed to diagnostic/preoperative work up has not been characterized. We examined the costs of imaging and biopsy among women enrolled in Medicare who did and did not receive diagnostic/preoperative Magnetic Resonance Imaging (MRI).

MATERIALS AND METHODS:

Using Surveillance, Epidemiology and End Results (SEER)- Medicare data, we compared the per capita costs (PCC) based on amount paid, between diagnosis date and primary surgical treatment for a breast cancer diagnosis (2005-2009) with and without diagnostic/preoperative MRI. We compared the groups with and without MRI using multivariable models, adjusting for woman and tumor characteristics.

RESULTS:

Of the 53,653 women in the cohort, within the diagnostic/preoperative window, 20 % (N = 10,776) received diagnostic/preoperative MRI. Total unadjusted median costs were almost double for women with MRI vs. without ($2,251 vs. $1,152). Adjusted costs were higher among women receiving MRI, with significant differences in total costs ($1,065), imaging costs ($928), and biopsies costs ($138).

CONCLUSIONS:

Costs of diagnostic/preoperative workups among women with MRI are higher than those without. Using these cost estimates in comparative effectiveness models should be considered when assessing the benefits and harms of diagnostic/preoperative MRI.

To read more, see the following article on the PubMed website: PMID: 26920552