Table 2.
Costs of Breast Cancer Care, Year 2000 Dollars*
| Parameter | Estimate | Source |
| Mammography† | $82.51 | 41,42 |
| Total cost of an abnormal mammogram | $95.35 | 42,43 |
| Cost of treatment by phase and stage, mean±SD | 44 and SEER Medicare Data |
| BCS | BCS+RAD | MRM | |||||
|---|---|---|---|---|---|---|---|
| Ages 65–74 | Ages 75+ | Ages 65–74 | Ages 75+ | Ages 65–74 | Ages 75+ | ||
| Initial care‡ | |||||||
| DCIS | $2,398 | $1,759 | $7,304 | $6,949 | $6,074 | $5,818 | |
| ±$166 | ±$169 | ±$222 | ±$498 | ±$138 | ±$184 | ||
| Local | $6,329 | $3,905 | $8,810 | $7,936 | $6,475 | $6,340 | |
| ±$202 | ±$110 | ±$88 | ±$114 | ±$65 | ±$64 | ||
| Regional | $8,792 | $6,758 | $10,802 | $10,224 | $8,629 | $7,647 | |
| ±$411 | ±$384 | ±$230 | ±$396 | ±$98 | ±$111 | ||
| Distant | $11,682 | $6,413 | $23,691 | $15,241 | $9,540 | $8,810 | |
| ±$809 | ±$656 | ±$2,345 | ±$1,287 | ±$406 | ±$459 | ||
| Continuing care§ | |||||||
| DCIS | $600 | $1,128 | $708 | $120 | $444 | $564 | |
| ±$120 | ±$156 | ±$144 | ±$312 | ±$96 | ±$168 | ||
| Local | $1,140 | $792 | $528 | $636 | $756 | $612 | |
| ±$120 | ±$72 | ±$60 | ±$84 | ±$36 | ±$36 | ||
| Regional | $936 | $996 | $1,068 | $444 | $1,296 | $912 | |
| ±$300 | ±$192 | ±$120 | ±$192 | ±$48 | ±$48 | ||
| Distant | $4,272 | $3,732 | $4,572 | $2,424 | $2,796 | $1620 | |
| ±$756 | ±$708 | ±$804 | ±$660 | ±$336 | ±$288 | ||
| Terminal phase∥ | |||||||
| DCIS | $35,360 | $21,229 | $22,646 | $22,666 | $25,296 | $17,930 | |
| ±$2,317 | $1,647 | ±$5,830 | ±$9,383 | ±$2,504 | ±$1,866 | ||
| Local | $19,031 | $14,966 | $26,656 | $19,051 | $26,526 | $16,912 | |
| ±$1,408 | $650 | ±$1,345 | ±$1,054 | ±$656 | ±$341 | ||
| Regional | $22,712 | $14,572 | $28,012 | $20,087 | $23,126 | $17,229 | |
| ±$1,686 | $901 | ±$1,403 | ±$1,510 | ±$405 | ±$289 | ||
| Distant | $19,949 | $17,363 | $32,011 | $17,491 | $21,406 | $19,962 | |
| ±$1,180 | $1,128 | ±$1,690 | ±$1,324 | ±$992 | ±$681 | ||
| Monthly patient time costs (travel, treatment)¶ | 45–47 | ||||
|---|---|---|---|---|---|
| BCS | BCS+RT | Mastectomy | Chemotherapy | ||
| Initial phase | |||||
| All stages | $26/month | $91 | $61 | $39 | |
| Continuing phase | |||||
| DCIS/local | $5.08/year | $5.08 | $5.08 | $5.08 | |
| Regional/distant | $6.33/year | $6.33 | $6.33 | $6.33 | |
| Terminal phase | |||||
| All stages | $10/month | $10 | $10 | $10 | |
| Cost of tamoxifen over 5-year period# | Medical care cost | 48 | |||
| $6,352 | |||||
| Cost of adjuvant chemotherapy for initial treatment# | Medical care cost | ||||
| $4,725 | 48 |
All costs updated to 2000 using the medical care component of the consumer price index.49
Average among women who generally are not diagnosed with cancer.
The initial phase of care includes all costs incurred by breast cancer patients for the 12-month period following the date of diagnosis (e.g., initial diagnostic evaluation and staging, hospitalizations and surgery, and any adjuvant chemotherapy, medical visits, and laboratory procedures).44,50
The continuing care phase includes all costs incurred by breast cancer patients after the initial phase up to the 12 months prior to death (e.g., medical visits for surveillance, treatment of recurrences, hospitalizations, mammograms, and laboratory procedures, etc).44,50
Terminal care costs refer to all costs incurred by breast cancer patients in the last 12 months of life (e.g., hospitalizations, chemotherapy, laboratory procedures, and medical visits).44,50
Patient time costs were calculated based on estimated time valued at current average U.S. wage rates, even though many older women are not in the workforce.51
Because Medicare does not cover tamoxifen, we added these costs for estrogen receptor–positive women. Also, because rates of nonhormonal chemotherapy are low in older women, we added these costs to the initial care SEER-Medicare phase-specific costs for women who receive this therapy in the simulation.
BCS, breast-conserving treatment; RAD, radiation therapy; MRM, modified radical mastectomy; DCIS, ductal carcinoma in situ.