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Lumpectomy or mastectomy? Is breast conserving surgery too expensive?

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Abstract

In the last decade, breast cancer patients have enjoyed an increase inbreast conserving surgery (BCS). At present, modified radical mastectomy(MRM) and BCS offers equal expectations of survival. During the last fewyears, however, a drop in the frequency of BCS has been reported by severalauthors. Is this new trend due to economic concerns? To clarify the costs ofbreast cancer therapy (stage I and II), we review the literature and includea cost-utility and a cost-minimisation analysis comparing MRM and BCS.

The treatment cost (per patient) of BCS and MRM in Norway was calculated at$ 9,564 and $ 5,596, respectively. Employing a quality of lifegain in BCS of 0.03 (0–1 scale) and a 5% discount rate, thecost per QALY in BCS compared to MRM was $ 20,508. In cost-minimisinganalysis, BCS and mastectomy followed by reconstructive surgery had a costof $ 10,748 and $ 8,538, respectively. This indicates that BCSremains within reasonable cost and should not be displaced by mastectomy oneconomic grounds.

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Authors and Affiliations

  1. Department of Oncology, University Hospital of Tromsø, N-9038, Tromsø, Norway

    Jan Norum & Erik A. Wist

  2. Department of Economics, University of Tromsø, N-9037, Tromsø, Norway

    Jan Abel Olsen

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  1. Jan Norum
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  2. Jan Abel Olsen
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  3. Erik A. Wist
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Norum, J., Olsen, J.A. & Wist, E.A. Lumpectomy or mastectomy? Is breast conserving surgery too expensive?. Breast Cancer Res Treat 45, 07–14 (1997). https://doi.org/10.1023/A:1005804101106

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