An early economic evaluation of active surveillance for low-risk ductal carcinoma <i>in situ</i>

<b>Aim:</b> Perform early economic evaluation comparing active surveillance (AS) to surgery for women with low-risk ductal carcinoma <i>in situ</i>, a precursor of invasive breast cancer.<b>Materials & methods:</b> A 10-year incremental costs (€) and quality-adjusted life years (QALYs) were compared between a simulated cohort of women undergoing breast conserving surgery ± radiotherapy, and a cohort with a low-risk subgroup undergoing AS using a semi-Markov model. Scenario and headroom analyses evaluated a better-performing biomarker to select low-risk women for AS.<b>Results:</b> AS resulted in lower costs and survival, but higher QALYs (±0.40). Scenario analyses maintained survival outcomes and maximized QALYs.<b>Conclusion:</b> AS for low-risk ductal carcinoma <i>in situ</i> is cost-effective, but a better-performing biomarker to select low-risk women can maximize quality-adjusted outcomes.