scholarly journals Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China

2020 ◽  
Author(s):  
Qing Yang ◽  
Xiaorong Zhong ◽  
Wei Zhang ◽  
Ting Luo ◽  
Ping He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Early Breast Cancer ◽  
Medical Center ◽  
Treatment Options ◽  
Academic Medical Center ◽  
Breast Conserving Surgery ◽  
Surgical Approaches ◽  
Treatment Approaches

Abstract Background Both breast-conserving surgery and breast reconstruction surgery are less popular in China, although they can improve patients' quality of life. The main reason comes from the economy. There is currently no economic evaluation of different surgical treatment options for early breast cancer. Our study aimed to evaluate the long-term cost-utilities of different surgical treatment approaches for early breast cancer. The surgical approaches are including mastectomy(MAST), breast-conserving therapy(BCT), and mastectomy with reconstruction (MAST+RECON). Methods We applied the propensity score matching method to perform a 1: 1 match on patients undergoing these three types of surgery in a tertiary academic medical center from 2011 to 2017 to obtain a balanced sample of covariates between groups. A Markov model was established. Clinical data and cost data were obtained from the medical records. Health utility values were derived from clinical investigations. Strategies were compared using an incremental cost-effectiveness ratio (ICER). Results The total cost of MAST, MAST+RECON and BCT was $35,282.24, $69,428.82 and $73,661.08, respectively. The discounted quality-adjusted life year(QALYs) were 17.94, 18.71 and 20.49, respectively. Compared with MAST, MAST+RECON and BCT have an ICER of $106708.06/QALY and $15050.53/QALY, respectively. The ICER of BCT vs. MAST was less than the threshold of $27,931.04. The reliability and stability of the results were confirmed by Monte Carlo simulation and sensitivity analysis. Conclusions We believe that in the context of the limited resources in China, after comparing the three surgical approaches, BCT is the more cost-effective and preferred solution.

scholarly journals Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China

2020 ◽  
Author(s):  
Qing Yang ◽  
Xiaorong Zhong ◽  
Wei Zhang ◽  
Ting Luo ◽  
Ping He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Early Breast Cancer ◽  
Medical Center ◽  
Treatment Options ◽  
Academic Medical Center ◽  
Health Utility ◽  
Breast Conserving Surgery ◽  
Surgical Approaches

Abstract Background: Both breast-conserving surgery and breast reconstruction surgery are less popular in China, although they can improve patients' quality of life. The main reason comes from the economy. There is currently no economic evaluation of different surgical treatment options for early breast cancer. Our study aims to assess the economic impact and long-term cost-effectiveness of different surgical treatments for early breast cancer. The surgical approaches are including mastectomy (MAST), breast-conserving therapy (BCT), and mastectomy with reconstruction (MAST+RECON).Methods: We applied the propensity score matching method to perform a 1: 1 match on patients undergoing these three types of surgery in a tertiary academic medical center from 2011 to 2017 to obtain a balanced sample of covariates between groups. A Markov model was established. Clinical data and cost data were obtained from the medical records. Health utility values were derived from clinical investigations. Strategies were compared using an incremental cost-effectiveness ratio (ICER).Results: The total cost of MAST, MAST+RECON and BCT was $35,282.24, $69,428.82 and $73,661.08, respectively. The quality-adjusted life year (QALYs) were 17.94, 18.71 and 20.49, respectively. Compared with MAST, MAST+RECON and BCT have an ICER of $106708.06/QALY and $15050.53/QALY, respectively. The ICER of BCT vs. MAST was less than the threshold of $27,931.04. The reliability and stability of the results were confirmed by Monte Carlo simulation and sensitivity analysis.Conclusions: We believe that in the context of the limited resources in China, after comparing the three surgical approaches, BCT is the more cost-effective and preferred solution.

scholarly journals Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Yang ◽  
Xiaorong Zhong ◽  
Wei Zhang ◽  
Ting Luo ◽  
Ping He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Early Breast Cancer ◽  
Medical Center ◽  
Demographic Data ◽  
Treatment Options ◽  
Academic Medical Center ◽  
Surgical Approaches ◽  
Data Set

Abstract Background Both breast-conserving surgery and breast reconstruction surgery are less popular in China, although they can improve patients’ quality of life. The main reason comes from the economy. There is currently no economic evaluation of different surgical treatment options for early breast cancer. Our study aims to assess the economic impact and long-term cost-effectiveness of different surgical treatments for early breast cancer. The surgical approaches are including mastectomy (MAST), breast-conserving therapy (BCT), and mastectomy with reconstruction (MAST+RECON). Methods Based on demographic data, disease-related information and other treatments, we applied propensity score matching (PSM) to perform 1: 1 matching among patients who underwent these three types of surgery in the tertiary academic medical center from 2011 to 2017 to obtain a balanced sample of covariates between groups. A Markov model was established. Clinical data and cost data were obtained from the medical records. Health utility values were derived from clinical investigations. Strategies were compared using an incremental cost-effectiveness ratio (ICER). Results After PSM, there were 205 cases in each group. In the matched data set, the distribution of covariates was fully balanced. The total cost of MAST, MAST+RECON and BCT was $37,392.84, $70,556.03 and $82,330.97, respectively. The quality-adjusted life year (QALYs) were 17.11, 18.40 and 20.20, respectively. Compared with MAST, MAST+RECON and BCT have an ICER of $25,707.90/QALY and $14,543.08/QALY, respectively. The ICER of BCT vs. MAST was less than the threshold of $27,931.04. The reliability and stability of the results were confirmed by Monte Carlo simulation and sensitivity analysis. Conclusions We believe that in the context of the limited resources in China, after comparing the three surgical approaches, BCT is the more cost-effective and preferred solution.

Feasibility of integrating the Outcomes4Me smartphone navigation application into the care of breast cancer patients (FIONA).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1570-1570
Author(s):  
Steven J. Isakoff ◽  
Maya Said ◽  
Agnes H. Kwak ◽  
Eva Glieberman ◽  
Amanda Stroiney ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Pilot Study ◽  
Patient Engagement ◽  
Medical Center ◽  
Treatment Options ◽  
Academic Medical Center ◽  
Patient Reported ◽  
Clinical Trial Information

1570 Background: Patients diagnosed with breast cancer (BC) face complex decisions about their care and many studies have shown that improved patient engagement results in increased satisfaction and better outcomes. Patient engagement includes education, treatment option selection, symptom tracking and reporting, and clinical trial opportunities. We conducted a pilot study to determine the feasibility of introducing the Outcomes4Me patient engagement app into the standard of care experience of BC patients. Methods: This was a pilot study (NCT04262518) conducted at an academic medical center. Eligible patients had any subtype of stage 1-4 BC and were on any type of chemo-, hormonal-, targeted-, or radiation-therapy for BC during the study period. Participants downloaded the app on their smartphone and their app usage was evaluated. Surveys were administered at baseline and end of study. Clinicians caring for patients using the app were surveyed at the end of the study. The primary endpoint was feasibility, defined as at least 40% of patients engaging with the app at least 3 times over the 12-week study period. Additional endpoints included usability, satisfaction, correlation of patient reported data with the EHR, clinical trial matching, and patient experience. Results: Between June 2020 and December 2020, 107 patients enrolled; results are reported for 90 patients with complete data as of 1/24/21. Baseline demographics: median age 53 (range: 27-77); 90% White, 4% Black, 3% Asian; 66% had hormone positive/HER2-, 20% HER2+, and 13% triple negative BC; 31% had stage 4 disease. At study entry, 93% had never used an app to help with their disease or treatment options. Over the 12 week study period, 58% of patients engaged with the app at least 3 times, meeting the primary feasibility endpoint. Patients engaged with the app on average 5.5 days (range: 0-40) with 20% engaging on more than 10 days during the study. The mean System Usability Score was 71 (median = 76) and was similar across age groups. The 5 app features deemed most (‘somewhat’ or ‘very’) helpful were: background about their BC (76%), information about treatment options (74%), newsfeed about their BC (70%), symptom tracking (65%), and clinical trial information (65%). 53% said that the app helped them keep track of symptoms and 33% said they are more likely to explore or enroll in a clinical trial after using the app. Conclusions: Integration of the Outcomes4Me app into the care management of BC patients is feasible with acceptable usability. Our results suggest that use of a patient smartphone app may be helpful for many aspects of patient education and engagement for patients with BC. The results also suggest that this type of intervention can help patients better track their symptoms and make them aware of clinical trials, potentially facilitating the management of side effects and accelerating clinical trials recruitment. Clinical trial information: NCT04262518.

scholarly journals The Investigation and Management of Adenomyosis in Women Who Wish to Improve or Preserve Fertility

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Jin-Jiao Li ◽  
Jacqueline P. W. Chung ◽  
Sha Wang ◽  
Tin-Chiu Li ◽  
Hua Duan
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Treatment Options ◽  
Management Strategies ◽  
Definitive Treatment ◽  
Surgical Approaches ◽  
Child Bearing ◽  
Fertility Sparing

The management of adenomyosis remains a great challenge to practicing gynaecologists. Until recently, hysterectomy has been the only definitive treatment in women who have completed child bearing. A number of nonsurgical and minimally invasive, fertility-sparing surgical treatment options have recently been developed. This review focuses on three aspects of management, namely, (1) newly introduced nonsurgical treatments; (2) management strategies of reproductive failures associated with adenomyosis; and (3) surgical approaches to the management of cystic adenomyoma.

scholarly journals The experiences of women with breast cancer who undergo fertility preservation

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
T Dahhan ◽  
F van der Veen ◽  
A M E Bos ◽  
M Goddijn ◽  
E A F Dancet
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Academic Medical Center ◽  
Psychosocial Care ◽  
Phenomenological Approach ◽  
Starting Point ◽  
Competing Interest ◽  
Experiences Of Women

Abstract STUDY QUESTION How do women, who have just been diagnosed with breast cancer, experience oocyte or embryo banking? SUMMARY ANSWER Fertility preservation was a challenging yet welcome way to take action when confronted with breast cancer. WHAT IS KNOWN ALREADY Fertility preservation for women with breast cancer is a way to safeguard future chances of having children. Women who have just been diagnosed with breast cancer report stress, as do women who have to undergo IVF treatment. How women experience the collision of these two stressfull events, has not yet been studied. STUDY DESIGN, SIZE, DURATION We performed a multicenter qualitative study with a phenomenological approach including 21 women between March and July 2014. Women were recruited from two university-based fertility clinics. PARTICIPANTS/MATERIALS, SETTING, METHODS Women with breast cancer who banked oocytes or embryos 1–15 months before study participation were eligible. We conducted in-depth, face-to-face interviews with 21 women, which was sufficient to reach data saturation. MAIN RESULTS AND THE ROLE OF CHANCE The 21 women interviewed had a mean age of 32 years. Analysis of the 21 interviews revealed three main experiences: the burden of fertility preservation, the new identity of a fertility patient and coping with breast cancer through fertility preservation. LIMITATIONS, REASONS FOR CAUTION Interviewing women after, rather than during, fertility preservation might have induced recall bias. Translation of quotes was not carried out by a certified translator. WIDER IMPLICATIONS OF THE FINDINGS The insights gained from this study of the experiences of women undergoing fertility preservation while being newly diagnosed with breast cancer could be used as a starting point for adapting the routine psychosocial care provided by fertility clinic staff. Future studies are necessary to investigate whether adapting routine psychosocial care improves women’s wellbeing. STUDY FUNDING/COMPETING INTEREST(S) None of the authors in this study declare potential conflicts of interest. The study was funded by the Center of Reproductive Medicine of the Academic Medical Center.

Surgical Treatment Options of Breast Cancer-Related Lymphedema

2021 ◽  
Vol 9 (3) ◽  
Author(s):  
Summer E. Hanson ◽  
Carrie K. Chu ◽  
Edward I. Chang
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Treatment Options ◽  
Breast Cancer Related Lymphedema
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