scholarly journals Costs of breast cancer treatment incurred by women in Vietnam

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Tran Thu Ngan ◽  
Nguyen Bao Ngoc ◽  
Hoang Van Minh ◽  
Michael Donnelly ◽  
Ciaran O’Neill
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Online Survey ◽  
Service Use ◽  
Stage Iv ◽  
Stage Ii ◽  
Individual Level ◽  
Therapy Cost ◽  
The Mean ◽  
The Cost

Abstract Background There is a paucity of research on the cost of breast cancer (BC) treatment from the patient’s perspective in Vietnam. Methods Individual-level data about out-of-pocket (OOP) expenditures on use of services were collected from women treated for BC (n = 202) using an online survey and a face-to-face interview at two tertiary hospitals in 2019. Total expenditures on diagnosis and initial BC treatment were presented in terms of the mean, standard deviation, and range for each type of service use. A generalised linear model (GLM) was used to assess the relationship between total cost and socio-demographic characteristics. Results 19.3% of respondents had stage 0/I BC, 68.8% had stage II, 9.4% had stage III, none had stage IV. The most expensive OOP elements were targeted therapy with mean cost equal to 649.5 million VND ($28,025) and chemotherapy at 36.5 million VND ($1575). Mean total OOP cost related to diagnosis and initial BC treatment (excluding targeted therapy cost) was 61.8 million VND ($2667). The mean OOP costs among patients with stage II and III BC were, respectively, 66 and 148% higher than stage 0/I. Conclusions BC patients in Vietnam incur significant OOP costs. The cost of BC treatment was driven by the use of therapies and presentation stage at diagnosis. It is likely that OOP costs of BC patients would be reduced by earlier detection through raised awareness and screening programmes and by providing a higher insurance reimbursement rate for targeted therapy.

scholarly journals Costs of Breast Cancer Treatment Incurred by Women in Vietnam

2021 ◽  
Author(s):  
Tran Ngan ◽  
Nguyen Ngoc ◽  
Hoang Minh ◽  
Michael Donnelly ◽  
Ciaran O'Neill
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Online Survey ◽  
Service Use ◽  
Insurance Coverage ◽  
Stage Iv ◽  
Stage Ii ◽  
Screening Programs ◽  
The Mean ◽  
The Cost

Abstract Background: There is a paucity of research on the cost of breast cancer (BC) treatment from the patient’s perspective in Vietnam.Methods: Individual-level data about out-of-pocket (OOP) expenditures on use of services were collected from women treated for BC (n=202) using an online survey and a face-to-face interview at two tertiary hospitals in 2019. Total expenditures on diagnosis and initial BC treatment were presented in terms of the mean, standard deviation, and range for each type of service use. A generalised linear model (GLM) was used to assess the relationship between total cost and socio-demographic characteristics.Results: 19.3% of respondents had stage 0/I BC, 68.8% had stage II, 9.4% had stage III, none had stage IV. The most expensive OOP elements were targeted therapy with mean cost equal to 649.5 million VND ($28,025) and chemotherapy at 36.5 million VND ($1,575). Mean total OOP cost related to diagnosis and initial BC treatment (excluding targeted therapy cost) was 61.8 million VND ($2,667). The mean OOP costs among patients with stage II and III BC were, respectively, 66% and 148% higher than stage I.Conclusions: BC patients in Vietnam incur significant OOP costs. The cost of BC treatment was driven by use of therapies and presentation stage at diagnosis. It is likely that OOP costs of BC patients would be reduced by earlier detection through raised awareness and screening programs and by providing a higher insurance coverage rate for targeted therapy.

The Impact of Primary Tumor Surgery on Survival in HER2 Positive Stage IV Breast Cancer Patients in the Current Era of Targeted Therapy

2020 ◽  
Vol 27 (8) ◽  
pp. 2711-2720 ◽  
Author(s):  
Ross Mudgway ◽  
Carlos Chavez de Paz Villanueva ◽  
Ann C. Lin ◽  
Maheswari Senthil ◽  
Carlos A. Garberoglio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Stage Iv ◽  
Tumor Surgery ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Stage Iv Breast Cancer ◽  
The Impact

Detection of bone marrow involvement in breast cancer with magnetic resonance imaging.

1994 ◽  
Vol 12 (7) ◽  
pp. 1415-1421 ◽  
Author(s):  
S M Sanal ◽  
F W Flickinger ◽  
M J Caudell ◽  
R M Sherry
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Serum Alkaline Phosphatase ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
Stage Ii ◽  
Stage Iii ◽  
Mri Findings ◽  
Two Stage ◽  
Bone Scans

PURPOSE To evaluate the value of magnetic resonance imaging (MRI) in detecting bone marrow metastases in patients with breast cancer. PATIENTS AND METHODS Twenty-three patients with breast cancer in various stages (stage IV, 11; stage III, five; stage II, seven) were evaluated for bone marrow involvement. MRIs of marrow from lumbar spine, pelvis, and proximal femora were obtained with a 1.5-Tesla unit. All patients underwent bilateral bone marrow aspirations and biopsies for histologic evaluation and immunostaining with monoclonal antibody (MoAB) against low-molecular weight cytokeratin (CAM 5.2). Marrow MRI findings were compared with technetium 99m bone scans. Patients with stage II or III disease were monitored for clinical outcome. Possible correlation of MRI findings with serum alkaline phosphatase level was explored. RESULTS Fourteen of 23 patients showed MRI abnormalities suggestive of metastatic marrow disease (stage IV, nine; stage III, two; stage II, three). In six patients with abnormal MRIs, histology and MoAB immunostaining confirmed marrow involvement (stage IV, five; stage III, zero; stage II, one). In the other eight patients with MRI abnormalities, neither of these methods confirmed the presence of marrow metastasis. Four of five operable breast cancer (stage II-III) patients with an abnormal initial MRI showed additional abnormalities on follow-up examination and developed metastatic disease within 5 to 18 months demonstrable by conventional clinical methods. Conversely, none of the operable patients with negative MRIs developed recurrent disease at 3 to 16 months (Student's t test, P = .01). Nine patients with a normal MRI had no evidence of marrow involvement with histologic or MoAB immunostaining (stage IV, two; stage III, two; stage II, five). Of 14 patients with abnormal MRIs, bone scans were normal in seven and failed to show corresponding abnormalities in six. Elevated serum alkaline phosphatase levels showed a direct relationship with abnormal bone scans indicating extensive bony involvement, but failed to correlate with positive marrow MRIs. CONCLUSION MRI is a promising new technique to detect occult marrow involvement in breast cancer patients. There is a good correlation between abnormal marrow MRI and early development of clinical metastatic disease in patients with stage II to III disease.

Triple-negative breast cancer: Epidemiology, characteristics, and survival in a Lebanese cohort

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22228-e22228
Author(s):  
M. Ghosn ◽  
C. Hajj ◽  
F. Nasr ◽  
F. El Karak ◽  
G. Abadjian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Positive Family History ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
University Hospital ◽  
Stage Iii

e22228 Background: Breast cancer (BC) is the most common malignancy in women in Lebanon. Triple negative (TN) phenotype is known to be associated with an increased likelihood of recurrence and death. The purpose of this study is to determine the incidence, characteristics and survival of TN BC patients in a Medical Oncology department in a University Hospital in Lebanon. Methods: We retrospectively reviewed the pathology of all women with breast cancer that were seen in our institution between 1997 and 2008. TN BC patients (pts) were defined as those that were negative for all 3 receptors (estrogen, progesterone and HER2neu on immunohistochemistry). Pts' characteristics and survival of TN women were analyzed. Results: Of the 1599 breast cancer pts, 155 (9.7%) had a triple negative phenotype. Median age was 52 years. A positive family history of breast/ovarian cancer was found in 15 pts (10%). Pathology studies showed: invasive ductal carcinoma component in 138 pts (89%), pure medullary carcinoma in 7 pts (5%), pure invasive lobular carcinoma in 6 pts (4%), pure mucinous carcinoma in 3 pts (2%) and epidermoid carcinoma in 1 pt (1%). A grade III was found in 98 of specimens (63%). Twenty-six pts (17%) presented with stage I, 73 (47%) with stage II, 37 (24%) with stage III and 19 (12%) with stage IV. Twelve percent had inflammatory breast cancer. After a median follow up of 17 months (mths), 43 pts had relapsed (5 stage I, 18 stage II and 20 stage III). The most common sites of relapse were brain (in 20 % of cases), lungs (in 20% of cases) and bone (in 11% of cases). Five- year disease free survival and 5-year overall survival were respectively 75% and 88% for stage I, 58% and 72% for stage II and 40% and 63% for stage III. Adjuvant therapy was administered to 96% of pts among which a taxane-based regimen was used in 38% of cases . Median survival for stage IV was 19 mths with a first line taxane-based regimen used in 50% of cases. Conclusions: The incidence of TN BC in Lebanon is similar to that described in the literature. It has an aggressive course. Focus on understanding the biology of this particular BC subtype is essential for determining targets for future therapeutic options. No significant financial relationships to disclose.

scholarly journals Radiation therapy for oral melanoma in dogs: A retrospective study

2018 ◽  
Vol 48 (4) ◽  
Author(s):  
Simone Carvalho dos Santos Cunha ◽  
Katia Barão Corgozinho ◽  
Franciele Basso Fernandes Silva ◽  
Kassia Valéria Gomes Coelho da Silva ◽  
Ana Maria Reis Ferreira
Keyword(s):  
Radiation Therapy ◽  
Retrospective Study ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Response To Treatment ◽  
Mean Survival Time ◽  
Oral Melanoma ◽  
The Mean

ABSTRACT: Our retrospective study evaluated the survival of 24 dogs with unresectable malignant melanoma treated with radiation therapy. Fifteen dogs were treated with radiation therapy (RT) and chemotherapy (CT), five with surgery followed by RT and CT, three with palliative RT, and one with electrochemotherapy associated with RT. All dogs were treated with an orthovoltage Stabilipan I. The protocol used was three or four weekly fractions of 8 Gy. Carboplatin was administered every 21 days, a total of four times. Five percent of dogs were classified as having stage I melanoma, 17% as stage II, 50% as stage III, and 17% as stage IV. Sixty-four percent had a partial response to treatment, 29% achieved complete remission, and 7% remained in a stable disease state. The mean survival time was 390 days for stage I, 286 days for stage II, 159 days for stage III, and 90 days for stage IV. We concluded that radiation therapy can be considered a viable alternative for the palliative treatment of canine oral melanoma.

scholarly journals Complement-fixation and complement-fixation-inhibition titres against the Bedsonia antigen in sera of trachoma patients

1962 ◽  
Vol 60 (1) ◽  
pp. 21-28 ◽  
Author(s):  
A. L. Terzin ◽  
B. V. Birtašević
Keyword(s):  
Soluble Group ◽  
Complement Fixation ◽  
Stage Iv ◽  
Indicator System ◽  
Inhibition Test ◽  
Statistical Analyses ◽  
Stage Ii ◽  
Satisfactory Explanation ◽  
Mean Values ◽  
The Mean

Sera of 132 selected patients belonging to stages II, III or IV of clinical trachoma have been tested by CF-test against the ether-soluble, group-specific Bedsonia antigen, as well as by CF-inhibition test against an indicator system of the same group-reactive specificity.On the basis of the serological results obtained, the following conclusions have been advanced:Trachoma patients do not develop group-specific CF-inhibiting antibodies in their sera.The group-reactive (anti-Bedsonia) CF-titres found in sera of trachoma patients represent residual titres developed in response to past infections with agents other than trachoma. There is no satisfactory explanation for the fact that in trachoma patients neither CF, nor CF-inhibiting antibodies develop against the group-reactive Bedsonia antigen, which is known to be produced also by the virus of trachoma.Statistical analyses revealed that, in the group of stage IV trachomas, the mean values of the anti-Bedsonia CF-titres were significantly higher than those found in the groups of stage II or III, as well as that the factors responsible for that difference must be other than the duration of the trachoma.A hypothesis was advanced to explain the appearance of the highest group specific mean-titre revealed by the group of stage IV cases.

scholarly journals Quantifying the Costs to Different Funders over Five-Years for Women Diagnosed with Breast Cancer in Queensland, Australia: A Data Linkage Study

2021 ◽  
Vol 18 (24) ◽  
pp. 12918
Author(s):  
Daniel Lindsay ◽  
Emily Callander
Keyword(s):  
Breast Cancer ◽  
Emergency Department ◽  
Service Use ◽  
Breast Cancer Diagnosis ◽  
Linkage Study ◽  
Female Breast Cancer ◽  
High Survival ◽  
Administrative Dataset ◽  
Financial Burdens ◽  
The Cost

Individuals diagnosed with breast cancer have the highest rates of survival among all cancer types. Due to high survival, the costs of breast cancer to different healthcare funders are of interest. This study aimed to describe the cost to public hospital and private health funders and individuals due to hospital and emergency department (ED) admissions, as well Medicare items and pharmaceuticals over five years for Queensland women with breast cancer. We used a linked administrative dataset, CancerCostMod, limited to Queensland female breast cancer diagnoses between July 2011 and June 2013 aged 18 years or over who survived for 5 years (n = 5383). Each record was linked to Queensland Health Admitted Patient Data Collection, Emergency Department Information Systems, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between July 2011 and June 2018. Total costs for different healthcare funders as a result of breast cancer diagnoses were reported, with high costs and service use identified in the first six months following a breast cancer diagnosis. After the first six months post-diagnosis, the financial burdens incurred by different healthcare funders for breast cancer diagnoses in Queensland remain steady over a long period. Recommendations for reducing long term costs are discussed.

Primary adrenocortical carcinoma: A retrospective review of The Cleveland Clinic Foundation experience between 1995 to 2002

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18614-18614
Author(s):  
N. J. Tirgan ◽  
A. H. Hamrahian
Keyword(s):  
Adrenocortical Carcinoma ◽  
Malignant Tumors ◽  
Cleveland Clinic ◽  
Stage Iv ◽  
Distant Metastases ◽  
Treated Group ◽  
Stage Ii ◽  
Stage Iii ◽  
Entire Group ◽  
The Mean

18614 Background: Primary adrenocortical carcinoma (PAC) is a rare disease with a incidence of 1 per million. PAC’s are highly malignant tumors with guarded prognosis. Radical surgery is the treatment of choice. Methods: The pathology database and medical charts of these patients were retrospectively reviewed. Results: There were 14 females, 8 males, and 95% were caucasion. The mean age was 49.2 ± 11.8 years (females 51.6 years, males 45 years). The mean size of the tumor was 12.6 ± 5.1 cm (range of 3.6 to 25 cm). Thirteen patients (59.1%) presented with left and nine (40.9%) with right sided PAC. Seventy- two percent of the patients had abdominal, back, and/or flank pain. Forty five percent of patients had symptoms related to hypercortisolism and/or hyperandrogenism. Twelve patients (55%) had functional tumors (hypercortisolism 67%, hyperandrogenism 42%, and DHEA-S hypersecretion 42%) and ten were non-functional. Five percent of the tumors were classified as stage I, 33% were stage II, 38% were stage III, and 24% were stage IV. Twelve patients (55%) had distant metastases (liver 75%, lung 67%, retroperitoneum 33%, kidney 17%, contra-lateral adrenal gland 17%). All 22 patients had adrenalectomies (open 91%; laparoscopic 9%). The microscopic margin of resection were negative in 14 and positive in 6 patients. The information for 18 patients were evaluable for treatment. Eight patients received post-op therapy. Four patients received Mitotane (o,p’-DDD) alone (three died at 2, 29, and 213 months; and one is alive at 38 months after diagnosis). Three patients received both Mitotane and chemotherapy (two died at 3 and 43 months, one is alive at 140 months). One patient received only chemotherapy and died at 8 months. Ten patients received no post-op therapy. The estimated 5-year survival for the entire group was 48% (Kaplan-Meier survival estimate, 95% confidence interval). The estimated 5-year survival for stage III was 33%, and for stage IV was 30%. There were no deaths in patients with stage II group. The estimated 5-year survival for the treated group (8 patients) was 33% and 58% for the untreated group (10 patients). Conclusions: In PACs, surgery remains the main method of therapy. In our experience, Mitotane with or without chemotherapy did not improve survival. No significant financial relationships to disclose.

Estimating the real cost of adjuvant (adj) trastuzumab (T) in patients (pts) with HER-2+ (H+) early stage breast cancer (ESBC): Potential impact of reduced use of expensive oncology drugs (EOD) in metastatic breast cancer (MBC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6534-6534
Author(s):  
R. O'Cearbhaill ◽  
E. Wilson ◽  
A. deFrein ◽  
Z. Qadir ◽  
D. McDonnell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Metastatic Breast ◽  
Cost Effective ◽  
Societal Cost ◽  
University Hospital ◽  
The Real ◽  
Real Cost ◽  
The Mean ◽  
The Cost

6534 Background: Pts with H+ early stage BC have an approximately 35% risk of developing MBC (BCIRG001). T has been reported to reduce this risk by 33–50%, but costs approximately €;30k per pt, a burden some health systems deem unsustainable. This risk reduction might however result in decreased utilization of EOD in MBC, lowering the societal cost of adjT. We attempted to estimate the cost per relapse prevented (Crp), and the real cost of adjT, allowing for potential savings in prevented cases of MBC. Methods: We conducted a retrospective analysis of the mean cost per pt of AdjT (1 year) and of EOD in MBC in St. Vincent's University Hospital. We devised an equation to calculate the Crp for adj T. Crp=[A-M(NRA/104)]/[NRA/104] where A = cost per pt for adjT, M = EOD cost per pt with MBC, N = % of pts relapsing after standard adj treatment, RA = % reduction in the risk of relapse after adjT (over standard adj). Results: H+ pts with MBC received T (average 34 cycles €;2,400 each) with a combination of the following drugs: docetaxel (x8 €;1,500), gemcitabine (x5 €;1,215), capecitabine (x8 €;400), vinorelbine ( x19 €;187). Only 2 pts received bevacizumab (Bev) (x15 €;3,000). In our unit the mean EOD cost per pt with MBC was €;108k. The cost per relapse prevented for a 33% and a 50% reduction in relapse rate would be €;152k and €;63k, respectively. Furthermore, assuming a 50% reduction in the rate of relapse (from 35 to 17.5%) the real cost of adjT per pt treated is not €;30k, but approximates €;11k (€;30k×100-{17.5x €;108k}). Conclusions: The reduced utilization of EOD in MBC likely has a very beneficial impact on the societal cost of adjT. Confirmation of the efficacy of shorter adjT (e.g. FinnHer) would produce further benefit. The increasing use of novel EOD in MBC e.g. Bev would make adjT even more cost-effective. No significant financial relationships to disclose.

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