Cost Savings in Breast Imaging

Switching to digital mammography has the potential to provide a significant cost savings over the long-term compared with the use of film, according to the results of a large Spanish population-based study.

“Although the introduction of digital mammography in screening programs is a natural consequence of the digitalization of radiology departments, our study puts together the comparison between screen-film and digital mammography from all points of view and its consequences are assessed in the long term, resulting in a positive evaluation of the introduction of digital mammography for screening,” Mercé Comas, MD, of the Hospital del Mar, Barcelona, told Diagnostic Imaging.

According to Comas, assessing the potential cost savings of digital mammography is important because millions of asymptomatic women undergo the procedure every year. Although other studies have assessed the costs of mammography itself, this study included the costs related to additional confirmatory tests and cancer treatment as well. 

Comas and colleagues created a simulation model that reproduced the breast cancer screening process of women aged 50 to 69 and combined it with the natural history of breast cancer. The model initially included 100,000 women projected out during a 20-year period, but more than 150,000 new women were also included according to the aging of the Spanish population. The results of the study were published in PLoS One.

Data indicated that although screening with digital mammography had a higher cost, this cost was offset by savings seen with the decreased need for additional tests associated with digital screening. The recall rate for digital mammography was 6.1 percent compared with 6.6 percent for film mammography. According to Comas, not only was there economical savings, but also fewer invasive diagnostic tests and earlier detection of cancers.

At one year, digital mammography was associated with a €165,540 savings. By 10 years, it was associated with more than €1.1 million in savings and by 20 years, more than €2.8 million in savings compared with film mammography. These amounts represented 4.5 percent and 8.1 percent of the overall cost associated with screen mammography, respectively.

“Given that our objective was to compare the population-based screening program using one technology versus the same program using the other, the costs and inefficiencies associated to the process itself of switching from screen-film to digital mammography have not been included,” the researchers wrote. “Further research would be needed to estimate the economic impact of the process of change and how increased short-term costs may hamper implementation of digital mammography throughout all the Spanish screening units.”