The cost-effectiveness of digital breast tomosynthesis in a population breast cancer screening program.

Objectives: To evaluate at which sensitivity digital breast tomosynthesis (DBT) would become cost-effective compared to digital mammography (DM) in a population breast cancer screening program, given a constant estimate of specificity.

Methods: In a microsimulation model, the cost-effectiveness of biennial screening for women aged 50-75 was simulated for three scenarios: DBT for women with dense breasts and DM for women with fatty breasts (scenario 1), DBT for the whole population (scenario 2) or maintaining DM screening (reference). For DM, sensitivity was varied depending on breast density from 65 to 87%, and for DBT from 65 to 100%.

A modelling study to evaluate the costs and effects of lowering the starting age of population breast cancer screening.

Background: Because the incidence of breast cancer increases between 45 and 50years of age, a reconsideration is required of the current starting age (typically 50years) for routine mammography. Our aim was to evaluate the quantitative benefits, harms, and cost-effectiveness of lowering the starting age of breast cancer screening in the Dutch general population.

Methods: Economic modelling with a lifelong perspective compared biennial screening for women aged 48-74years and for women aged 46-74years with the current Dutch screening programme, which screen women between the ages of 50 and 74years.