Evidenced-Based Radiation Treatment Tied to Cost Savings in Early Stage Breast Cancer

Lumpectomy with RT can be a safe and effective alternative to mastectomy for women with early-stage breast cancer.
Lumpectomy with RT can be a safe and effective alternative to mastectomy for women with early-stage breast cancer.

Evidenced-based adjuvant radiation treatments in women with early-stage breast cancer was tied to reduced health care costs.1

"It's important to look for opportunities in cancer treatment where we can safely reduce health care costs without compromising excellent outcomes," said Rachel Greenup, MD, MPH of Duke Cancer Institute in Durham, North Carolina, study author, in a press release.2

The rising cost of breast cancer treatments highlights the need for selecting the most high-value and evidenced-based cancer treatments. Previous studies have shown lumpectomy with radiation treatment (RT) to be a safe and effective alternative to mastectomy in women with early-stage breast cancer. Further, lumpectomy without RT may be a safe alternative in carefully selected patients, according to the paper.

Using data from the National Cancer Database, national RT treatment patterns for women with T1 or T2 N0 invasive breast cancer treated with lumpectomy were identified. The RT regimens included in the study were conventional fractionated whole-breast irradiation, hypofractionated whole-breast irradiation, and RT omission. Estimated cost differences for RT were based on the Medicare Physician Fee Schedule. The actual cost of the RT received was then compared to the cost of RT the patient was eligible for based on clinical trial criteria.

The investigators found 57% of the patients eligible for RT omission or shorter RT actually received longer and more expensive RT regimens. Cost estimates were $256.2 million for the evidenced-based RT compared to $420.2 million for the actual treatments. Evidenced-based adjuvant RT treatments were associated with a potential savings of $164 million or 39% reduction in costs.1

"Our study provides an example of a win-win situation, where patients can receive high-quality, evidence-based cancer care while also reducing the treatment burden for patients and the health care system," Dr Greenup continued in the statement.2

References

1. Greenup RA, Blitzblau RC, Houck KL, et al. Cost implications of an evidence-based approach to radiation treatment after lumpectomy for early-stage breast cancer. J Oncol Pract. 2017 Mar 14. doi: 10.1200/JOP.2016.016683 [Epub ahead of print]

2. Reducing radiation could safely cut breast cancer treatment costs [news release]. Durham, NC: Duke Health; March 9, 2017; updated March 14, 2017. https://corporate.dukehealth.org/news-listing/reducing-radiation-could-safely-cut-breast-cancer-treatment-costs. Accessed March 20, 2017.

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