Table 3.
Model parameters, data sources and assumptions
| Pathology diagnosis distribution from the Breast Cancer Surveillance Consortium (BCSC)a | Invasive | DCIS | Atypia | Benign |
|---|---|---|---|---|
| Ages 40–49 | 11.0% | 4.9% | 3.2% | 80.9% |
| Ages 50–59 | 20.2% | 8.5% | 4.3% | 67.1% |
| Ages 60–69 | 29.6% | 8.8% | 3.1% | 58.4% |
| Ages 70–79 | 35.9% | 9.2% | 3.0% | 51.9% |
| Ages ≥80 | 47.0% | 11.3% | 3.1% | 38.6% |
| Cost components in 2013 U.S. Dollars | Costs | Source | Assumptions |
|---|---|---|---|
| Treatment for DCIS within year following diagnosis | $13,376.08 | Yabroff (2008) [7] | |
| Treatment for invasive carcinoma within year following diagnosis | $27,043.02 | Yabroff (2008) [7] | Prevalence-weighted care costs for regional and distant breast cancer |
| Hormone therapyd | $1469.65 | Average wholesale price for Tamoxifen 20 mg/day | |
| ‘‘Follow-up’’ digital mammogram | $277.62 | Medicare | Digital screening mammogram with associated professional and technical fees |
| Bilateral screening breast MRI | $1103.34 | Medicare | |
| Core breast biopsyb | $936.90 | Plevritis (2006) [6] | Ultrasound-guided core needle biopsy and stereotactic biopsy, weighted based on their respective probabilities |
| Open surgical biopsy | $1657.39 | ||
| Second opinion breast pathology interpretationc | $140.17 | Medicare | Tissue exam by pathologist with associated professional and technical fees |
a
Based on observed breast pathology outcomes among women 504,032 women undergoing 994,085 screening mammograms in 2004 through 2008
b
The cost of core breast biopsy is a combined value from the costs of ultrasound-guided core needle biopsy and stereotactic biopsy, weighted based on their respective probabilities
c
The cost of core biopsy’s additional reading is the summation of costs from the CPT codes for a tissue exam by pathologist and the associated professional and technical components
d
Based on average wholesale price for Tamoxifen given at a regimen of 20 mg/day