Xiao Wu, Abstract Co-Author: Nothing to Disclose

Vivek Bihari Kalra MD, Presenter: Nothing to Disclose

Brian Haas MD, Abstract Co-Author: Nothing to Disclose

Liane Elizabeth Philpotts MD, Abstract Co-Author: Nothing to Disclose

To determine if age is a variable independent of mammographic density in recall costs of breast tomosynthesis compared to 2D mammography.

Diagnostic workups resulting from screening recalls performed with tomosynthesis and 2D mammography were tabulated from a one year period at a single institution in a HIPAA compliant, IRB-waived study. Unnecessary diagnostic workups were defined as those that subsequently returned to screening or had biopsies with non-malignant pathology. All imaging was performed on Selenia Dimensions units (Hologic, Bedford, MA). Patients were evaluated with tomosynthesis or 2D without preferential assignment. The direct costs of basic diagnostic mammographic imaging, advanced diagnostic imaging, biopsy procedure costs, and pathology interpretation costs were assessed using 2013 regional facility Medicare payment values. Multiple linear regression analysis was performed to determine significance of age and density as independent variables.

During the one-year period, 13,174 patients underwent screening mammography, of which 6,116 had tomosynthesis and 7,058 had 2D mammograms. 516 (8.4%) of tomosynthesis patients were recalled and 826 (11.7%) of 2D mammography patients were recalled (p<0.0001). No significant difference in patient characteristics, including number of patients lost to followup, were seen between the two groups. Tomosynthesis demonstrates an 8.4% decrease in recall costs between each decade age group independent of density (p=0.01), leading to 27.4% more savings in the 40-49 age group compared to 70+. Tomosynthesis demonstrates a 4.0% decrease in recall costs for each stepwise increase in breast density independent of age (p=0.004), leading to 12.5% greater savings in the extremely dense group compared to predominantly fatty group. Overall cost reduction of 17.1% was seen, as previously presented.

Age, grouped by decade, independently is more than twice as significant as mammographic density in determining recall cost benefits in combined breast tomosynthesis compared to 2D mammography. There was an 8.4 % decrease in recall costs between each decade age group independent of density, leading to 27.4% more savings in the 40-49 age group compared to 70+.

Age is independently more than twice as significant as mammographic density in determining recall cost benefits in combined breast tomosynthesis compared to 2D mammography.

Wu, X, Kalra, V, Haas, B, Philpotts, L, Recall Costs in Breast Tomosynthesis: Age as a Variable Independent of Mammographic Density  .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016547.html