Table 5.

Incremental costs per quality-adjusted life year gained^* by breast density, risk level, screening interval, and age for 3 models.

Density	RR	Screening Frequency	Age 50–74			Age 65–74
			Model E	Model W	Model GE	Model E	Model W	Model GE
Fatty	1.0	Triennial	68,777	117,753	43,098	100,058	131,294	27,639
		Biennial	122,007	123,132	232,710	109,587	212,665	104,235
		Annual	389,195	586,116	Dom	435,881	516,979	>1,000,000
	1.3	Triennial	50,231	83,220	27,022	70,716	92,938	15,785
		Biennial	83,577	86,426	133,826	75,433	135,221	67,152
		Annual	231,495	309,654	>1,000,000	258,193	286,643	799,501
	2.0	Triennial	30,910	W Dom	10,364	42,229	58,276	3,004
		Biennial	50,526	50,084†	65,297	46,300	70,911	32,912
		Annual	122,540	148,375	392,745	141,183	146,961	263,493
	4.0	Triennial	14,969	22,663	†	19,130	W Dom	†
		Biennial	22,802	23,295	19,932	21,242	30,054	5,331
		Annual	54,906	56,451	95,362	69,089	62,251	76,840
Scattered	1.0	Triennial	69,714	72,156	18,509	W Dom	55,051	14,112
		Biennial	111,605	75,673	104,454	101,612	Dom	61,723
		Annual	317,991	288,199	Dom	382,578	612,349	>1,000,000
	1.3	Triennial	50,010	51,493	9,683	W Dom	60,785	5,449
		Biennial	75,416	53,967	63,057	72,488	73,479	39,636
		Annual	186,322	171,038	488,376	224,322	201,088	450,818
	2.0	Triennial	31,053	29,757	641	W Dom	38,299	†
		Biennial	43,721	31,198	28,182	42,160	42,347	15,956
		Annual	96,584	85,607	144,723	120,188	104,553	159,293
	4.0	Triennial	15,414	12,179	†	W Dom	17,507	Dom
		Biennial	19,733	13,116	5,116	20,076	17,977	‡
		Annual	44,019	32,452	39,105	61,818	39,362	42,660
Het. dense	1.0	Triennial	57,924	W Dom	8,016	W Dom	75,197	611
		Biennial	85,241	60,333†	50,421	85,145	96,863	23,104
		Annual	222,789	185,805	268,798	279,586	290,534	179,689
	1.3	Triennial	42,324	41,815	2,179	60,235	54,355	†
		Biennial	61,309	42,551	31,442	61,760	60,225	11,809
		Annual	137,983	116,700	134,915	169,196	174,243	97,850
	2.0	Triennial	26,726	23,375	†	W Dom	31,637	†
		Biennial	35,235	26,574	12,543	36,446	36,762	478
		Annual	75,747	57,557	56,331	99,035	85,503	44,784
	4.0	Triennial	13,432	8,534	Dom	W Dom	13,298	Dom
		Biennial	16,745	9,256	‡	18,673	13,814	‡
		Annual	36,845	22,339	14,716	57,264	32,355	8,752
Dense	1.0	Triennial	50,563	52,953	3,017	W Dom	63,918	†
		Biennial	68,216	55,420	27,942	75,917	77,061	8,555
		Annual	148,014	129,536	89,425	187,329	203,860	60,177
	1.3	Triennial	37,937	36,486	†	W Dom	45,929	†
		Biennial	49,172	40,051	16,293	55,033	52,754	2,547
		Annual	101,399	87,230	56,264	130,774	130,339	36,740
	2.0	Triennial	24,715	20,626	†	W Dom	26,367	Dom
		Biennial	30,291	23,683	4,631	35,097	32,766	‡
		Annual	60,577	47,687	25,753	82,794	71,187	15,070
	4.0	Triennial	13,169	7,130	Dom	W Dom	10,180	Dom
		Biennial	14,856	7,823	‡	19,207	11,669	Dom
		Annual	31,433	18,224	4,407	52,645	26,834	§

Note: Incremental ratios bold if values are <$100,000, a common threshold for least costly and most effective strategies (dominant). Unless otherwise indicated, triennial strategies are compared to no screening. Breast density categories shown as: fatty, almost entirely fat; scattered, scattered fibroglandular density; het. dense, heterogeneously dense; and dense, extremely dense.

Abbreviations: RR, relative risk; Dom, more expensive and less effective (strongly dominated); W Dom, more expensive and more effective but less efficient (weakly dominated).

^*Costs and quality-adjusted life years discounted at 3% per year. Quality-adjusted life years include disutility from participation in screening mammography.

^†Strategy with no screening is strongly dominated. Triennial is the least costly strategy for comparison.

^‡Strategy with biennial screening is the least costly.

^§Strategy with annual screening is the least costly