“One of the most surprising things in this study was that the average patient treated with mastectomy and reconstruction who had private insurance results in a complication cost of $10,000 per patient, and this is approximately $9,000 higher than the cost of complications with lumpectomy plus whole breast irradiation,” said Smith. Similarly, in the SEER-Medicare cohort, mastectomy plus reconstruction was associated with an increase of approximately $2,500 per patient compared with lumpectomy plus whole breast irradiation.
Most of the complications associated with mastectomy plus reconstruction were related to infections and wound complications associated with the reconstruction.
When evaluating non-complication costs, mastectomy plus reconstruction was again the most expensive treatment in the MarketScan cohort, at approximately $15,000 more than lumpectomy and whole breast irradiation. In contrast, in the SEER-Medicare cohort, mastectomy plus reconstruction was slightly less expensive by about $700 than lumpectomy plus whole breast irradiation. “This indicates that mastectomy plus reconstruction is not terribly more expensive if you can avoid complications in older patients who are Medicare beneficiaries,” he said.
The value of lumpectomy plus whole breast irradiation could be further improved if radiation oncologists adopt shorter, more cost-effective schedules for delivering breast irradiation, added Smith.
Smith BD, Jiang J, Shih Y-CT, et al. Complication and economic burden of local therapy options for early breast cancer. Presented at the 2015 San Antonio Breast Cancer Symposium; San Antonio, Texas, December 8-12, 2015. Abstract S3-07.
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