Economic evaluation of diagnostic follow-up after primary treatment for breast cancer: Results of the Working Group on Economic-Organizational Aspects of Follow-up (original) (raw)
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Breast Cancer Research, 2010
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Health and quality of life outcomes, 2017
Women treated for breast cancer are followed-up for monitoring of treatment effectiveness and for detecting recurrences at an early stage. The type of follow-up received may affect women's reassurance and impact on their quality of life. Anxiety and depression among women with breast cancer has been described, but little is known about how the intensity of the follow-up can affect women's psychological status. This study was undertaken to evaluate the effects of intensive vs. less-intensive follow-up on different health outcomes, to determine what are women's preferences and values regarding the follow-up received, and also assess the costs of these different types of follow-up. A systematic review following standard Cochrane Collaboration methods was carried out to assess the efficacy of intensive follow-up versus non-intensive follow-up in breast cancer patients. Two additional reviews on women's preferences and economic evidence were also carried out. The search w...
534 Individualized breast cancer follow-up; cost-effectiveness of various scenarios
European Journal of Cancer Supplements, 2010
This study investigates the follow-up of breast cancer and took place from September 2007 until February 2008. One of the main goals of follow-up is to improve the survival of patients. Follow-up influences survival by detecting local recurrences and second primary tumors in an early stage, thereby reducing the risk of metastases.
Asian Pacific journal of cancer prevention : APJCP, 2016
Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection r...
Clinical Interventions in Aging, 2015
Objective: An increase in breast cancer incidence has been documented in Italy and in other countries, and some women decide by themselves to undergo diagnostic examinations outside the official screening campaigns. The aim of this paper was to analyze -in terms of effectiveness, appropriate access, and related costs -the path spontaneously followed by a sample of Italian women for the early diagnosis of breast cancer. Subjects and methods: A total of 143 women who consecutively referred themselves to the breast cancer outpatient facilities at the Sant'Andrea University Hospital in Rome from May to June 2007 were enrolled in the study, gave their consent, and were screened according to their individual risk factors for breast cancer. The entire diagnostic and therapeutic path followed in the previous 2 years by each of them, either at Sant'Andrea or in other medical facilities, was reviewed and evaluated in terms of its operative efficiency and fair economic value. Results: The subjects' mean age was 47.5 years (standard deviation 13.6 years); 55% of the women were 50 years old (28% 40 years), and were thus not included in the official screening campaigns; 97 women (70%) were requesting a routine control; and 49% of them had already undergone four to seven examinations before the enrollment, although no major risk factor was present in 73.5%. After enrollment in the study, nine of the patients had surgical interventions performed on them at Sant'Andrea's, identifying five invasive carcinomas and two ductal in situ carcinomas and two benign lesions. Operative efficiency and fair economic value were found to be optimal only in diagnostic/therapeutic paths followed at Sant'Andrea. Conclusion: The diagnostic path at Sant'Andrea's specialized center for breast cancer diagnosis and therapy is characterized by higher operative efficiency and more sustainable costs than at general hospitals, outpatient facilities run by local health authorities, or private medical centers. This result seems to confirm the present tendency to refer high-risk patients for breast cancer directly to breast units like the one at Sant'Andrea.
Reducing the cost of diagnosis of breast carcinoma
Cancer, 2001
This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of ultrasound and imaging-guided percutaneous biopsy procedures in the diagnosis of breast carcinoma. The biopsy procedures included 14-gauge core biopsy, fine-needle biopsy and vacuum-assisted core biopsy device. Type of intervention Secondary prevention: diagnosis. Economic study type Cost-effectiveness analysis. Study population The study population comprised women with mammograms deemed to be sufficiently suspicious to warrant biopsy. Setting The setting was tertiary care. The economic study was carried out in Birmingham (AL), USA.
La radiologia medica
Introduction In 2016, the Italian Group for Mammography Screening and the Italian College of Breast Radiologists by the Italian Society of Medical and Interventional Radiology recommended that screening programmes and specialist breast centres actively invite women with a history of breast cancer to follow-up imaging. Objective A survey of breast centres associated with Senonetwork, the Italian network of breast cancer services, has offered the opportunity to assess the implementation of this recommendation. Methods A national, cross-sectional, voluntary, online survey was developed, pre-tested, and administered during the months July-October 2020. Five of the 73 questionnaire items concerned breast cancer follow-up. Results The response rate was 82/128 (65%). Of the 82 respondent centres, 69 (84%) were involved in a screening programme. Fifty-six (68%) reported the presence of a programme of active invitation to breast cancer follow-up targeted at patients living in their catchment area, with a significant north-to-south gradient. Four centres (5%) reported that the screening programme was responsible for actively initiating follow-up during the 10-year period since diagnosis. Only after 10 years did the proportion increase moderately. Conclusion Screening programmes have still a marginal role in active breast cancer follow-up.
Economic evaluation of breast cancer screening: A review
Cancer practice
The authors provide a review of the economic evaluation literature of breast cancer screening and identify important trends and gaps in the literature. Healthcare resources are limited and economic evaluation plays a critical role in resource allocation, healthcare policy, and clinical decisions. Many economic evaluations of medical practice, however, are unreliable and do not use appropriate analytic techniques. Three important trends were observed. First, two economic evaluation methods are dominant. Second, a wide range of cost estimates exists across studies. Third, a lack of standardization exists across studies with regard to basic economic evaluation principles. These findings should be considered when conducting future research, analyzing economic evaluations of breast cancer screening, and developing clinical guidelines. Concerns about cost containment in healthcare make it necessary for physicians and clinical administrators to take an active role in resource allocation de...