Radiation Therapy Cost-Effective in Patients With Early-Stage Breast Cancer
Overall costs of radiation therapy for early-stage breast cancer do not burden the health care system when analyzed in relation to survival benefit, according to the results of a single-institution study presented at the San Antonio Breast Cancer Symposium (December 5-9, 2017; San Antonio, TX).
Radiation therapy is frequently used as part of a treatment platform for women with clinical stage IA breast cancer. However, the contributions of radiation therapy to the overall cost of care has not been extensively studied.
Tomas Dvorak, MD, Orlando Health (Orlando, FL), and colleagues performed a retrospective chart review of 110 women treated at their institution between January 2014 and December 2014. Researchers determined which therapeutic treatments women received, then performed a financial review to identify actual technical revenue. The study included data from all treated women, regardless of insurance status or type.
All patients underwent surgery, with the majority (69%) receiving a lumpectomy; the remaining women received mastectomy with reconstruction (26%) or mastectomy alone (5%). Twenty percent received chemotherapy.
Although 77% of women consulted a radiation oncologist, radiation was delivered to 57% (3D, 92%; IMRT, 8%). The majority of women (55%) received conventionally fractionated radiation therapy.
Overall, the most common treatment pathways were lumpectomy with radiation (46%), mastectomy with reconstruction alone (18%), and lumpectomy alone (14%). The study showed that concordance with national treatment guidelines exceeded 90%.
The overall cost of care was $6.3 million, of which radiation comprised $1.1 million (17%). Other cost contributors included chemotherapy ($2.4 million; 38%), surgery ($2.1 million; 33%), and other related costs, including lab work, imaging, and emergency department visits ($700,000).
“Radiation therapy was used in approximately 60% of patients but accounted for less than 20% of the overall costs to the health care system,” researchers concluded. “Given the demonstrated survival benefit of radiation therapy in the care of breast cancer patients, and our high concordance with national guidelines, radiation therapy in our cancer center provides high value to our patients as we move toward value-based episodes of care.”—Cameron Kelsall