Table A1.
Outcomes, cost-effectiveness, and threshold costs for routine screening with liquid biopsies per 1000 women screened over their lifetime.
| Median Tumor Size for Screen Detection, cm |
Specificity, % | False Positives | QALYs-Gained | Total Costs, USD 1000 | ICER, USD 1000 per QALY- Gained |
Liquid Biopsy Maximum Price, USD |
|---|---|---|---|---|---|---|
| Liquid biopsy screening with 91% DCIS sensitivity | ||||||
| 1.39 | 88 | 914.3 | 36 | 6990 | - | - |
| 1.39 | 96 | 406.3 | 40 | 6879 | - | - |
| 1.39 | 100 | 0 | 43 | 6786 | −91.2 | 195 |
| 1.33 | 88 | 914.2 | 37 | 6999 | - | - |
| 1.33 | 96 | 406.3 | 41 | 6888 | −162.4 | 171 |
| 1.33 | 100 | 0 | 44 | 6796 | −58.6 | 202 |
| 1.27 | 88 | 914.0 | 39 | 7010 | - | - |
| 1.27 | 96 | 406.2 | 42 | 6899 | −52.3 | 179 |
| 1.27 | 100 | 0 | 45 | 6807 | −39.9 | 210 |
| 1.21 | 88 | 913.8 | 40 | 7022 | - | - |
| 1.21 | 96 | 406.1 | 44 | 6911 | −30.4 | 186 |
| 1.21 | 100 | 0 | 47 | 6819 | −30.4 | 217 |
| 1.15 | 88 | 913.6 | 42 | 7035 | 9.3 | 156 |
| 1.15 | 96 | 406.0 | 45 | 6924 | −19.3 | 193 |
| 1.15 | 100 | 0 | 48 | 6832 | −23.4 | 224 |
| 1.09 | 88 | 913.4 | 43 | 7050 | 9.5 | 164 |
| 1.09 | 96 | 405.9 | 47 | 6939 | −12.6 | 201 |
| 1.09 | 100 | 0 | 50 | 6847 | −18.2 | 232 |
| 1.03 | 88 | 913.2 | 45 | 7068 | 9.5 | 173 |
| 1.03 | 96 | 405.8 | 49 | 6957 | −7.8 | 210 |
| 1.03 | 100 | 0 | 52 | 6868 | −13.7 | 241 |
| Median tumor size results in up to 100% sensitivity for invasive BC | ||||||
| 0.61 | 88 | 910 | 59 | 7273 | 13.5 | 235 |
| 0.61 | 100 | 0 | 65 | 7071 | 1.9 | 303 |
| 0.01 | 88 | 863 | 43 | 10,882 | - | - |
| 0.01 | 100 | 0 | 49 | 10,689 | - | - |
| Liquid biopsy screening with 0% DCIS sensitivity | ||||||
| 1.39 | 88 | 922.7 | 30 | 7122 | - | - |
| 1.39 | 96 | 409.7 | 33 | 7010 | - | - |
| 1.39 | 100 | 0 | 36 | 6918 | - | - |
| 1.33 | 88 | 922.5 | 31 | 7132 | - | - |
| 1.33 | 96 | 409.7 | 35 | 7020 | - | - |
| 1.33 | 100 | 0 | 38 | 6927 | - | - |
| 1.27 | 88 | 922.3 | 33 | 7143 | - | - |
| 1.27 | 96 | 409.6 | 36 | 7031 | - | - |
| 1.27 | 100 | 0 | 39 | 6939 | - | - |
| 1.21 | 88 | 922.1 | 34 | 7155 | - | - |
| 1.21 | 96 | 409.5 | 38 | 7044 | - | - |
| 1.21 | 100 | 0 | 41 | 6951 | −115.1 | 161 |
| 1.15 | 88 | 921.9 | 35 | 7169 | - | - |
| 1.15 | 96 | 409.4 | 39 | 7057 | - | - |
| 1.15 | 100 | 0 | 42 | 6964 | −27.7 | 169 |
| 1.09 | 88 | 921.8 | 37 | 7184 | - | - |
| 1.09 | 96 | 409.3 | 41 | 7072 | 86.8 | - |
| 1.09 | 100 | 0 | 44 | 6979 | −11.7 | 177 |
| 1.03 | 88 | 921.4 | 39 | 7202 | - | - |
| 1.03 | 96 | 409.2 | 43 | 7090 | 27.4 | 156 |
| 1.03 | 100 | 0 | 46 | 6998 | −4.4 | 187 |
| Median tumor size results in up to 100% sensitivity for invasive BC | ||||||
| 0.61 | 88 | 918 | 53 | 7413 | 29.6 | 183 |
| 0.61 | 100 | 0 | 60 | 7210 | 9.4 | 253 |
| 0.01 | 88 | 869 | 37 | 11,173 | - | - |
| 0.01 | 100 | 0 | 43 | 10,979 | - | - |
Results are presented compared to no screening, except the incremental cost-effectiveness ratios for the liquid biopsies, which are compared to routine screening with mammography and diagnostic follow-up with tissue biopsy. Life-years, quality adjusted life-years, and total costs were discounted with a rate of 3% per year. In case of a negative ICER, a liquid biopsy saved costs and yielded quality-adjusted life years compared to digital mammography. Abbreviations: BC, breast cancer; QALYs, quality-adjusted life years; ICER, incremental cost-effectiveness ratio; DCIS, ductal carcinoma in situ; NAC, not acceptable; DOM, dominated.