Annual breast cancer screenings using mammograms and magnetic resonance imaging are cost-effective for women ages 35 to 54 who have the BRCA1 genetic mutation, according to a study published in the May 24 issue of the Journal of the American Medical Association, Reuters Health reports (Reuters Health, 5/23). About one in 400 people is believed to have either the BRCA1 or BRCA2 mutation, both of which are believed to increase the chance of developing breast and ovarian cancers (Kaiser Daily Women's Health Policy Report, 3/22). Sylvia Plevritis, assistant professor of radiology at the Stanford University School of Medicine, and colleagues created a model using economic and health outcomes for women ages 25 to 69 to evaluate the cost-effectiveness of screening women with BRCA1 and BRCA2 mutations with both an MRI and a mammogram (Reuters Health, 5/23). The researchers found that "[b]reast MRI screening is more cost-effective for BRCA1 than BRCA2 mutation carriers" and that "cost-effectiveness varies greatly by age" (Plevritis et al., JAMA, 5/24). Although the study finds that adding annual MRI to mammography is cost-effective for women ages 35 to 54 who have the BRCA1 mutation because they are at a greater risk of developing breast cancer, the additional screening is not cost-effective for women younger than age 35 or older than age 55. The screening strategy might be more cost-effective for women with the BRCA1 mutation because cancer in those women is more aggressive than in women with the BRCA2 mutation (Reuters Health, 5/23). The findings could increase pressure on insurers and physicians to provide MRI screening to the high-risk group, who traditionally only receive mammograms and manual exams, the Washington Post reports (Washington Post, 5/24).

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