Model structure of cost-effectiveness analysis on different gBRCA testing policies.
Breast Cancer, BRCA-positive
ENDOMETRIAL CANCER, BREAST CANCER, RECURRENCE, BILATERAL BREAST CANCER
FH family history, DF disease-free state.Each Markov model cycle was 1 year, and the time horizon was 20 years. Based on several epidemiological investigations of BC patients, the base-case model assumed that the mean age of the affected women is 40 years old [To comply with the clinical situation, we assumed that the affected women would undergo standard treatment following the NCCN and the Chinese Anti-Cancer Association Committee of Breast Cancer Society (CACA-BC) guidelines. Standard treatment is defined as local treatment plus systemic treatment following the current guidelines for BC treatment after diagnosis. Three therapeutic strategies were considered throughout the model: (1) BRCA-negative patients would receive standard treatment; (2) undetected BRCA-positive patients would receive standard treatment with increased risks of bilateral breast cancer and endometrial cancer; (3) BRCA-positive patients would receive standard treatment, wherein high-risk patients would receive PARPi and RROs (for details, refer to Annex Once recurrence is experienced in BRCA-mutant BCs, olaparib will be administered and maintained for 1 year [The primary outcomes are quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratios (ICERs) [