A review of the cost-effectiveness of Tc-99m sestamibi scintimammography in diagnosis of breast cancer in Taiwanese women with indeterminate mammographically dense breast |
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Authors: | Chen Yi-Shan Wang Wei-Hua Chan Tam Sun Shung-Shung Kao Albert |
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Affiliation: | Institute of Industrial Engineering and Enterprise information of Tunghai University, Taichung, Taiwan. a5604@www.cmch.org.tw |
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Abstract: | In general, biopsy is the preferred management method for women with indeterminate mammographically dense breasts. In this review, we describe a decision analysis model comparing technetium-99m methoxyisobutylisonitrile (Tc-99m sestamibi) scintimammography and excisional biopsy as breast cancer evaluation strategies for hypothetical cohorts of estimated 16,000-40,000 women with indeterminate mammographic probability of malignancy because of mammographically dense breasts. In cost-effectiveness analysis, quantitative decision tree sensitivity analysis was used to compare the conventional excision biopsy alone strategy (strategy A) with decision strategy for screening with Tc-99m sestamibi scintimammography before excision biopsy (strategy B) after an indeterminate mammogram. Strategy B showed a cost saving of US dollars 649,600-1,624,000 in reducing the cost of unnecessary biopsies. The total cost of strategy B showed a cost saving of US dollars 123,075-307,776 compared to strategy A. The analysis data indicate that Tc-99m sestamibi scintimammography can save the cost of unnecessary biopsies in Taiwanese women with non-diagnostic mammogram because of mammographically dense breasts. |
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