Induced costs of low-cost screening mammography.

Telephone follow-up in a recent low-cost ($50) mammography screening project in Orange County, California, was done to determine the detection rate and the induced costs of detection of small breast cancers. Because 403 of 2,261 (18%) women screened required additional evaluation and the cost of evaluation per abnormal mammogram averaged $607, the actual cost per cancer detected was $25,500. At least five cancers were detected per 1,000 women screened, and only 17% of the cancers involved the axillary lymph nodes. The costs of screening mammograms accounted for less than one-third of total costs, with surgical consultations and biopsies for benign disease representing the major induced costs of screening.