Risk-Reducing Mastectomy Cost-Effective With Breast Cancer Risk ≥35 Percent

MONDAY, July 28, 2025 (HealthDay News) — Undergoing risk-reducing mastectomy (RRM) seems to be cost-effective for women aged 30 to 55 years with a lifetime breast cancer (BC) risk of 35 percent or higher, according to a study published online July 24 in JAMA Oncology.

Xia Wei, Ph.D., from the London School of Hygiene & Tropical Medicine, and colleagues defined lifetime BC risk thresholds for RRM in an economic evaluation using a decision-analytic Markov model. The cost-effectiveness of RRM was compared to BC screening and medical prevention (tamoxifen or anastrozole) in a simulated cohort.

In the simulated cohort of 100,000 30-year-old women, the researchers found that RRM became cost-effective at a 34 percent lifetime BC risk using the £30,000 per quality-adjusted life-year (QALY) gained and compared with the U.K. willingness-to-pay (WTP) threshold. The identified lifetime BC risk thresholds for RRM to be cost-effective were 31, 29, 29, 32, 36, and 42 percent among women aged 35, 40, 45, 50, 55, and 60 years, respectively, using the £30,000 per QALY WTP threshold. For women aged 30 to 55 years with a lifetime BC risk of at least 35 percent, undergoing RRM was deemed cost-effective, with more than 50 percent of simulations cost-effective in a probabilistic sensitivity analysis. For women with a lifetime BC risk of 35 percent or higher, offering RRM could potentially prevent approximately 6,538 BCs or about 11 percent of the 58,756 BC cases occurring annually among women in the United Kingdom.

“The results could have significant clinical implications to expand access to RRM beyond BRCA1/BRCA2/PALB2 pathogenic variant carriers, and could potentially prevent 6,500 BC cases annually,” the authors write. “Future studies evaluating the acceptability, uptake, and long-term impact of RRM among these women are needed.”

One author disclosed ties to the biopharmaceutical industry.

Abstract/Full Text