Obtaining previous mammograms for comparison: usefulness and costs

Area of Science:

• Radiology
• Oncology
• Health Economics

Background:

• Mammography is crucial for early breast cancer detection.
• Comparison with prior mammograms can improve diagnostic accuracy.
• The logistical and financial implications of obtaining prior mammograms are not fully understood.

Purpose of the Study:

• To evaluate the clinical utility of comparing current mammograms with all previous examinations.
• To assess the costs and time associated with obtaining prior mammograms from external facilities.

Main Methods:

• A review of 1432 randomly selected screening mammography examinations from 1992.
• Data collection on availability of prior mammograms, clinical impact of comparisons, and costs incurred.
• Analysis of the success rate and expenses related to acquiring external mammograms.

Main Results:

• 87% of women had prior mammograms; 22% were from outside facilities and often unobtainable (51% not retrieved).
• Comparison influenced clinical management in 35 cases, leading to biopsies or further imaging, and avoiding others.
• Two cancers were detected due to comparison; costs averaged $12.52 per retrieved external mammogram.

Conclusions:

• Comparing mammograms positively impacts clinical management and cancer detection in a subset of cases.
• Obtaining prior mammograms, particularly from other institutions, is costly and has a low retrieval rate.
• The substantial costs and logistical challenges necessitate careful policy development regarding the acquisition of prior mammograms.