Table 2.
Cost of breast screening and adjunct testing in early and late cohorts*
| Category | Cost per beneficiary | Cost per procedure | ||||
|---|---|---|---|---|---|---|
| 2001–2002 | 2008–2009 | P | 2001–2002 | 2008–2009 | P | |
| Screening mammography | 44 (61) | 63 (83) | <.001 | 75 (33) | 101 (25) | <.001 |
| Digital | 3 (20) | 48 (80) | <.001 | 116 (42) | 115 (15) | <.001 |
| Film | 41 (58) | 15 (37) | <.001 | 73 (31) | 73 (13) | <.001 |
| Screening computer-aided detection | 1 (3) | 6 (9) | <.001 | 18 (7) | 12 (2) | <.001 |
| Screening cost subtotal | 44 (62) | 68 (91) | <.001 | 76 (33) | 110 (28) | <.001 |
| Diagnostic mammography | 4 (22) | 9 (39) | <.001 | 61 (32) | 96 (35) | <.001 |
| Digital | <1 (7) | 8 (37) | <.001 | 110 (43) | 106 (32) | .28 |
| Film | 4 (21) | 2 (13) | <.001 | 59 (30) | 65 (26) | <.001 |
| Diagnostic computer-aided detection | <1 (1) | 1 (3) | <.001 | 22 (11) | 11 (4) | <.001 |
| Breast ultrasound | 3 (18) | 4 (20) | <.001 | 64 (27) | 67 (21) | <.001 |
| Breast MRI | <1 (14) | 2 (42) | <.001 | 624 (430) | 524 (377) | .12 |
| Other imaging † | 2 (25) | 3 (43) | .07 | 73 (132) | 148 (235) | <.001 |
| Breast biopsy ‡ | 23 (189) | 25 (201) | .75 | 897 (687) | 1034 (600) | <.001 |
| Adjunct testing cost subtotal | 32 (210) | 43 (254) | <.001 | 221 (434) | 259 (428) | <.001 |
| TOTAL screening-related costs | 76 (225) | 112 (275) | <.001 | 105 (201) | 140 (199) | <.001 |
| Aged <75 y total cost | 101 (248) | 151 (318) | <.001 | 105 (192) | 141 (204) | <.001 |
| Aged ≥75 y total cost | 58 (204) | 83 (236) | <.001 | 106 (212) | 139 (191) | <.001 |
* Costs presented in 2009 US dollars, mean (SD). MRI = magnetic resonance imaging.
† Other imaging includes positron emitting tomography imaging; computed tomography of head, brain, thorax, abdomen; magnetic resonance imaging of brain, brainstem; radiologic examination of surgical specimen; three-dimensional rendering; bone and joint imaging; and radiopharmaceutical localization of tumor.
‡ Biopsy cost includes cost for anesthesia, pathology, breast-related procedures, and hospitalization on day of biopsy as indicated in Supplementary Table 1 (available online). In per procedure analysis, these costs are assigned to the day of biopsy if they occurred within 1 day before through 7 days after biopsy but are not otherwise included.