Feig Stephen
Department of Radiological Sciences, UC Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA.
Radiol Clin North Am. 2010 Sep;48(5):879-91. doi: 10.1016/j.rcl.2010.06.002.
Screening mammography performed annually on all women beginning at age 40 years has reduced breast cancer deaths by 30% to 50%. The cost per year of life saved is well within the range for other commonly accepted medical interventions. Various studies have estimated that reduction in treatment costs through early screening detection may be 30% to 100% or more of the cost of screening. Magnetic resonance imaging (MRI) screening is also cost-effective for very high-risk women, such as BRCA carriers, and others at 20% or greater lifetime risk. Further studies are needed to determine whether MRI is cost-effective for those at moderately high (15%-20%) lifetime risk. Future technical advances could make MRI more cost-effective than it is today. Automated whole-breast ultrasonography will probably prove cost-effective as a supplement to mammography for women with dense breasts.
从40岁起每年对所有女性进行乳腺钼靶筛查，已使乳腺癌死亡率降低了30%至50%。每年挽救一条生命的成本完全在其他普遍接受的医疗干预措施的成本范围内。各项研究估计，通过早期筛查发现而降低的治疗成本可能是筛查成本的30%至100%或更多。对于高危女性，如携带BRCA基因者以及其他终生风险达20%或更高的女性，磁共振成像（MRI）筛查同样具有成本效益。还需要进一步研究以确定MRI对于终生风险处于中度偏高（15% - 20%）的人群是否具有成本效益。未来的技术进步可能会使MRI比现在更具成本效益。对于乳腺致密的女性，自动全乳超声检查作为乳腺钼靶检查的补充，可能会被证明具有成本效益。
