Strengths and limitations
HER2-negative
For the first time, we indicate that the universal testing for gBRCA-mutant HER2-negative BC patients, together with adjuvant use of PARPi is cost-effective based on the OlympiA trial. This analysis has advantages. First, our model is characterised using a clinical pathway based on NCCN BC or the CACA-BC guidelines [Nevertheless, there are limitations to the present study. The study assessed only the cost-effectiveness of different gBRCA testing policies in the USA or China. Nevertheless, for low- and middle-income countries, owing to a lack of real-world data, the results of the present study should be interpreted cautiously. Moreover, we did not run the model and compare cost-effectiveness among different gBRCA screening policies in all BC patients due to limited evidence supporting PARPi in HER2-positive BCs with gBRCA mutations. Besides, we did not model the sensitivity and specificity of gBRCA testing as various literature has reported the gBRCA testing’s positive predictive value being 100% and negative predictive value being 93% or more [