ArticleBreast cancer research and treatment2011
Comparative effectiveness of screening and prevention strategies among BRCA1/2-affected mutation carriers.
Article in Breast cancer research and treatment, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 5 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Economic evaluation of breast MRI in screening - a systematic review and basic approach to cost-effectiveness analyses.Frontiers in oncology · 2023Pooled it
- Risk-Reducing Salpingo-Oophorectomy and the Use of Hormone Replacement Therapy Below the Age of Natural Menopause: Scientific Impact Paper No. 66 October 2021: Scientific Impact Paper No. 66.BJOG : an international journal of obstetrics and gynaecology · 2022Guideline
- Systematic Review of Cost-Effectiveness Models in Prostate Cancer: Exploring New Developments in Testing and Diagnosis.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022Pooled it
- Cost-Effectiveness Analysis of Imaging Modalities for Breast Cancer Surveillance AmongFrontiers in oncology · 2021Pooled it
- Cost-effectiveness and comparative effectiveness of cancer risk management strategies in BRCA1/2 mutation carriers: a systematic review.Genetics in medicine : official journal of the American College of Medical Genetics · 2018Pooled it
- Breast and ovarian cancer risk management in a French cohort of 158 women carrying a BRCA1 or BRCA2 germline mutation: patient choices and outcome.Familial cancer · 2012Trial
- Cost-effectiveness analysis (CEA) of ovarian cancer preventive strategies for women with BRCA1/2 pathogenic variants: the role of surveillance.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Evaluating high-risk breast cancer surveillance outcomes in BRCA mutation carriers.Breast cancer (Tokyo, Japan) · 2026Article
- Monte Carlo Tree Search for optimal cancer intervention strategies among BRCA mutation carriers.Computers in biology and medicine · 2025Article
- Article
- Cost-Effectiveness of Population-Based Multigene Testing for Breast and Ovarian Cancer Prevention.JAMA network open · 2024Article
- Prophylactic Interventions for Hereditary Breast and Ovarian Cancer Risks and Mortality in BRCA1/2 Carriers.Cancers · 2023Review
- Current and new frontiers in hereditary cancer surveillance: Opportunities for liquid biopsy.American journal of human genetics · 2023Review
- Longitudinal adherence to breast cancer surveillance following cancer genetic testing in an integrated health care system.Breast cancer research and treatment · 2023Article
- Article
- Cost-Effectiveness of Risk-Reducing Surgery for Breast and Ovarian Cancer Prevention: A Systematic Review.Cancers · 2022Review
- Feasibility, acceptability, and outcomes of a pilot intervention facilitating communication about family building between patients with inherited cancer risk and their partners.PEC innovation · 2022Article
- Hereditary Ovarian Cancer: Towards a Cost-Effective Prevention Strategy.International journal of environmental research and public health · 2022Review
- Cost-utility analysis of risk-reducing strategies to prevent breast and ovarian cancer in BRCA-mutation carriers in Switzerland.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Article
- Cost-effectiveness of multiparametric magnetic resonance imaging and MRI-guided biopsy in a population-based prostate cancer screening setting using a micro-simulation model.Cancer medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
unlabelledComparative effectiveness research has become an integral part of health care planning in most developed countries. In a simulated cohort of women, aged 30-65, who tested positive for BRCA1 or BRCA2 mutations, we compared outcomes of mammography with and without MRI, prophylactic oophorectomy with and without mastectomy, mastectomy alone, and chemoprevention.
methodsUsing Treeage 9.02 software, we developed Markov models with 25,000 Monte Carlo simulations and conducted probabilistic sensitivity analysis. We based mutation penetrance rates, breast and ovarian cancer incidence, and mortality rates, and costs in terms of 2009 dollars, on published studies and data from the Surveillance, Epidemiology, and End RESULTS (SEER) Program and the Centers for Medicare and Medicaid Services. We used preference ratings obtained from mutation carriers and controls to adjust survival for quality of life (QALYs).
resultsFor BRCA1 mutation carriers, prophylactic oophorectomy at $1,741 per QALY, was more cost effective than both surgeries and dominated all other interventions. For BRCA2 carriers, prophylactic oophorectomy, at $4,587 per QALY, was more cost effective than both surgeries. Without quality adjustment, both mastectomy and BSO surgeries dominated all other interventions. In all simulations, preventive surgeries or chemoprevention dominated or were more cost effective than screening because screening modalities were costly.
conclusionOur analysis suggested that among BRCA1/2 mutation carriers, prophylactic surgery would dominate or be cost effective compared to chemoprevention and screening. Annual screening with MRI and mammography was the most effective strategy because it was associated with the longest quality-adjusted survival, but it was also very expensive.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.