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John L. Dart Library
9 a.m. - 6 p.m.
Phone: (843) 722-7550
West Ashley Library
9 a.m. - 6 p.m.
Phone: (843) 766-6635
Folly Beach Library
9 a.m. - 1 p.m.
Phone: (843) 588-2001
Edgar Allan Poe/Sullivan's Island Library
Closed for renovations
Phone: (843) 883-3914
Wando Mount Pleasant Library
9 a.m. - 6 p.m.
Phone: (843) 805-6888
Village Library
9 a.m. - 6 p.m.
Phone: (843) 884-9741
St. Paul's/Hollywood Library
9 a.m. - 6 p.m.
Phone: (843) 889-3300
Otranto Road Library
9 a.m. - 6 p.m.
Phone: (843) 572-4094
Mt. Pleasant Library
9 a.m. – 6 p.m.
Phone: (843) 849-6161
McClellanville Library
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Keith Summey North Charleston Library
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John's Island Library
9 a.m. - 6 p.m.
Phone: (843) 559-1945
Hurd/St. Andrews Library
9 a.m. - 6 p.m.
Phone: (843) 766-2546
Miss Jane's Building (Edisto Library Temporary Location)
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Dorchester Road Library
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Phone: (843) 552-6466
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Phone: (843) 795-6679
Main Library
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Phone: (843) 805-6930
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Phone: (843) 805-6892
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Phone: (843) 805-6909
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Clinical Benefits, Harms, and Cost-Effectiveness of Breast Cancer Screening for Survivors of Childhood Cancer Treated With Chest Radiation : A Comparative Modeling Study.
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- Author(s): Yeh, Jennifer M. (AUTHOR); Lowry, Kathryn P. (AUTHOR); Schechter, Clyde B. (AUTHOR); Diller, Lisa R. (AUTHOR); Alagoz, Oguzhan (AUTHOR); Armstrong, Gregory T. (AUTHOR); Hampton, John M. (AUTHOR); Leisenring, Wendy (AUTHOR); Liu, Qi (AUTHOR); Mandelblatt, Jeanne S. (AUTHOR); Miglioretti, Diana L. (AUTHOR); Moskowitz, Chaya S. (AUTHOR); Oeffinger, Kevin C. (AUTHOR); Trentham-Dietz, Amy (AUTHOR); Stout, Natasha K. (AUTHOR)
- Source:
Annals of Internal Medicine. 9/1/2020, Vol. 173 Issue 5, p331-341. 11p. 4 Charts, 2 Graphs. - Source:
- Additional Information
- Subject Terms: AMERICAN Cancer Society Inc.; NATIONAL Institutes of Health (U.S.); CHILDHOOD cancer; CANCER survivors; MAGNETIC resonance mammography; SECONDARY primary cancer; BREAST cancer; EARLY detection of cancer; HOT flashes; BREAST tumor diagnosis; CHEST X rays; MAMMOGRAMS; MAGNETIC resonance imaging; MEDICAL protocols; COST effectiveness; RESEARCH funding; STATISTICAL models; BREAST tumors
- Abstract:
Background: Surveillance with annual mammography and breast magnetic resonance imaging (MRI) is recommended for female survivors of childhood cancer treated with chest radiation, yet benefits, harms, and costs are uncertain.Objective: To compare the benefits, harms, and cost-effectiveness of breast cancer screening strategies in childhood cancer survivors.Design: Collaborative simulation modeling using 2 Cancer Intervention and Surveillance Modeling Network breast cancer models.Data Sources: Childhood Cancer Survivor Study and published data.Target Population: Women aged 20 years with a history of chest radiotherapy.Time Horizon: Lifetime.Perspective: Payer.Intervention: Annual MRI with or without mammography, starting at age 25, 30, or 35 years.Outcome Measures: Breast cancer deaths averted, false-positive screening results, benign biopsy results, and incremental cost-effectiveness ratios (ICERs).Results Of Base-case Analysis: Lifetime breast cancer mortality risk without screening was 10% to 11% across models. Compared with no screening, starting at age 25 years, annual mammography with MRI averted the most deaths (56% to 71%) and annual MRI (without mammography) averted 56% to 62%. Both strategies had the most screening tests, false-positive screening results, and benign biopsy results. For an ICER threshold of less than $100 000 per quality-adjusted life-year gained, screening beginning at age 30 years was preferred.Results Of Sensitivity Analysis: Assuming lower screening performance, the benefit of adding mammography to MRI increased in both models, although the conclusions about preferred starting age remained unchanged.Limitation: Elevated breast cancer risk was based on survivors diagnosed with childhood cancer between 1970 and 1986.Conclusion: Early initiation (at ages 25 to 30 years) of annual breast cancer screening with MRI, with or without mammography, might reduce breast cancer mortality by half or more in survivors of childhood cancer.Primary Funding Source: American Cancer Society and National Institutes of Health. [ABSTRACT FROM AUTHOR]
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