This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Warren, J. L. Articles by Riley, G. F. Search for Related Content PubMed PubMed Citation Articles by Warren, J. L. Articles by Riley, G. F. Social Bookmarking                            What's this?

Costs of Treatment for Elderly Women With Early-Stage Breast Cancer in Fee-for-Service Settings

From the National Cancer Institute, Bethesda; Information Management Services, Silver Spring; and the Center for Medicare and Medicaid Services, Baltimore, MD.

Address reprint requests to Joan L. Warren, PhD, Applied Research Program, National Cancer Institute, Executive Plaza North, Rm 4005, 6130 Executive Blvd, Bethesda, MD 20892-7344; email: joan_warren @nih.gov.

PURPOSE: This study provides population-based estimates of the treatment costs for elderly women with early-stage breast cancer, with emphasis on costs of modified radical mastectomy (MRM) compared with breast-conserving surgery (BCS) and radiation therapy (RT).

PATIENTS AND METHODS: Women with breast cancer from the Surveillance, Epidemiology, and End Results cancer registries were linked with their Medicare claims, 1990 through 1998. Each claim was assigned to an initial, continuing, or terminal care phase after a cancer diagnosis. Mean monthly phase-specific costs were determined for all health care and for treatment related only to cancer. Cumulative long-term costs of care that accrue during a women’s remaining lifetime were calculated by treatment group.

RESULTS: Initial care costs for the 6 months after diagnosis for women who underwent BCS with RT were approximately $450 per month higher than for women with MRM. During the continuing-care phase, costs for women undergoing BCS with RT were significantly less expensive than for MRM cases. The two groups had similar costs in the terminal-care phase. Assuming the same survival distributions, long-term costs for women undergoing BCS with RT were not statistically different than for women undergoing MRM.

CONCLUSION: Although mastectomy was less costly in the initial phase, the lifetime costs of BCS with RT and mastectomy were equivalent. Thus, women’s preferences, resources to cover out-of-pocket costs, and life situations should be the major factors addressed in shared decision making about treatment options.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. L. Warren, K. R. Yabroff, A. Meekins, M. Topor, E. B. Lamont, and M. L. Brown Evaluation of Trends in the Cost of Initial Cancer Treatment J Natl Cancer Inst, June 18, 2008; 100(12): 888 - 897. [Abstract] [Full Text] [PDF]

				K. R. Yabroff, E. B. Lamont, A. Mariotto, J. L. Warren, M. Topor, A. Meekins, and M. L. Brown Cost of Care for Elderly Cancer Patients in the United States J Natl Cancer Inst, May 7, 2008; 100(9): 630 - 641. [Abstract] [Full Text] [PDF]

				J. S. Mandelblatt, W. F. Lawrence, J. Cullen, A. L. Stanton, J. L. Krupnick, L. Kwan, and P. A. Ganz Patterns of Care in Early-Stage Breast Cancer Survivors in the First Year After Cessation of Active Treatment J. Clin. Oncol., January 1, 2006; 24(1): 77 - 84. [Abstract] [Full Text] [PDF]

				B. K. Edwards, M. L. Brown, P. A. Wingo, H. L. Howe, E. Ward, L. A. G. Ries, D. Schrag, P. M. Jamison, A. Jemal, X. C. Wu, et al. Annual Report to the Nation on the Status of Cancer, 1975-2002, Featuring Population-Based Trends in Cancer Treatment J Natl Cancer Inst, October 5, 2005; 97(19): 1407 - 1427. [Abstract] [Full Text] [PDF]

				N. L. Keating, M. B. Landrum, E. Meara, P. A. Ganz, and E. Guadagnoli Do Increases in the Market Share of Managed Care Influence Quality of Cancer Care in the Fee-For-Service Sector? J Natl Cancer Inst, February 16, 2005; 97(4): 257 - 264. [Abstract] [Full Text] [PDF]

				S. Chang, S. R. Long, L. Kutikova, L. Bowman, D. Finley, W. H. Crown, and C. L. Bennett Estimating the Cost of Cancer: Results on the Basis of Claims Data Analyses for Cancer Patients Diagnosed With Seven Types of Cancer During 1999 to 2000 J. Clin. Oncol., September 1, 2004; 22(17): 3524 - 3530. [Abstract] [Full Text] [PDF]

				J. S. Mandelblatt, C. B. Schechter, K. R. Yabroff, W. Lawrence, J. Dignam, P. Muennig, Y. Chavez, J. Cullen, and M. Fahs Benefits and Costs of Interventions to Improve Breast Cancer Outcomes in African American Women J. Clin. Oncol., July 1, 2004; 22(13): 2554 - 2566. [Abstract] [Full Text] [PDF]

				N. L. Keating, M. B. Landrum, J. Z. Ayanian, E. P. Winer, and E. Guadagnoli Consultation With a Medical Oncologist Before Surgery and Type of Surgery Among Elderly Women With Early-Stage Breast Cancer J. Clin. Oncol., December 15, 2003; 21(24): 4532 - 4539. [Abstract] [Full Text] [PDF]

				C. E. Holmes and H. B. Muss Diagnosis and Treatment of Breast Cancer in the Elderly CA Cancer J Clin, July 1, 2003; 53(4): 227 - 244. [Abstract] [Full Text]

				L. C. Harlan and B. F. Hankey The Surveillance, Epidemiology, and End-Results Program Database as a Resource for Conducting Descriptive Epidemiologic and Clinical Studies J. Clin. Oncol., June 15, 2003; 21(12): 2232 - 2233. [Full Text] [PDF]

				D. Polsky, J. S. Mandelblatt, J. C. Weeks, L. Venditti, Y.-T. Hwang, H. A. Glick, J. Hadley, and K. A. Schulman Economic Evaluation of Breast Cancer Treatment: Considering the Value of Patient Choice J. Clin. Oncol., March 15, 2003; 21(6): 1139 - 1146. [Abstract] [Full Text] [PDF]