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BMJ 2006; 332 doi: (Published 01 June 2006) Cite this as: BMJ 2006;332:1327
  1. Alison Tonks (, associate editor

    MRI can be cost effective for breast cancer screening

    Current guidelines recommend yearly mammography for women with BRCA1 or BRCA2 mutations, even though it isn't particularly sensitive. Adding magnetic resonance imaging (MRI) might help, but since MRI is 10 times more expensive could it ever be cost effective?

    Researchers estimated that women screened by both methods every year would live two years longer with BRCA1 and about 18 months longer with BRCA2, compared with women screened by mammography alone. They also estimated that each extra quality adjusted life year (QALY) would cost between $45 000 (£24 000; €35 000) and $700 000, depending on the age range screened and the type of mutation. If we assume that society is willing to pay up to $100 000 for each extra QALY, then annual MRI would be cost effective for women with BRCA1 screened yearly between the ages of 35 and 54. The same programme would be too expensive for most women with BRCA2, …

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