MBI with Mammography Costly, but Improves Cancer Detection

September 29, 2015

Adding molecular breast imaging to mammography does add to screening cost, but it also increases cancer detection.

When molecular breast imaging (MBI) is added to screening mammography of women with dense breasts, the cancer detection rate increases, according to an article published in the American Journal of Roentgenology.

Researchers from the Mayo Clinic in Rochester, MN, examined additional diagnostic workup and costs that are generated by adding a single MBI examination to screenings of women who have dense breast tissue.

A total of 1,651 women who underwent mammography were enrolled in the study; 1,585 had complete reference standard. The women were followed for further tests and biopsies for at least one year.

The results showed with mammography screening alone, 175 of the 1,585 women (11%) were referred for diagnostic workup. Twenty patients (1.3%) underwent biopsy and five malignancies were detected. When the screening mammography was combined with MBI, 279 patients (17.6%) were referred for diagnostic workup. Sixty-seven (4.2%) underwent biopsy and 19 malignancies were found.[[{"type":"media","view_mode":"media_crop","fid":"41793","attributes":{"alt":"breast screening","class":"media-image media-image-right","id":"media_crop_1925915198715","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4447","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 136px; width: 160px; float: right;","title":"©Sam 72/Shutterstock.com","typeof":"foaf:Image"}}]]

The researchers found a biopsy rate of 0.9% (15 of 1,585) with just screening mammography and 3% (48 patients) with mammography plus MBI.

When evaluating costs, the researchers found that MBI added to the cost per patient. Mammography alone was $176 and the combination was $571, but they noted that the cost per cancer detected was lower for mammography plus MBI at $47,597, compared with mammography alone, which cost $55,851.

In a second study in the same journal, the researchers looked at the prevalence of background parenchymal uptake categories seen with MBI and its association with mammographic density and other clinical factors.

This study included 1,149 participants.

Background parenchymal uptake findings:

FindingsNumber of patients
Photopenic252 (22%)
Minimal-mild728 (63%)
Moderate or marked169 (15%)

There were 164 women with extremely dense breasts. Among this group, background parenchymal uptake was photopenic in 72 (44%), minimal-mild in 55 (34%), and moderate or marked in 37 (22%). "The moderate-marked group was younger on average, more likely to be premenopausal or perimenopausal, and more likely to be using postmenopausal hormone therapy than the photopenic or minimal-mild groups," the authors wrote.