Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1992 Mar;65(3):449–455. doi: 10.1038/bjc.1992.91

The cost of breast cancer recurrences.

S F Hurley 1, R M Huggins 1, R D Snyder 1, J F Bishop 1
PMCID: PMC1977600  PMID: 1558803

Abstract

Information about the costs of recurrent breast cancer is potentially important for targeting cost containment strategies and analysing the cost-effectiveness of breast cancer control programmes. We estimated these costs by abstracting health service and consumable usage data from the medical histories of 128 patients, and valuing each of the resources used. Resource usage and costs were summarised by regarding the recurrence as a series of episodes which were categorised into five anatomical site-based groups according to the following hierarchy: visceral, central nervous system (CNS), bone, local and other. Hospital visits and investigations comprised 78% of total costs for all episodes combined, and there were significant differences between the site-based groups in the frequency of hospital visits and most investigations. Total costs were most accurately described by separate linear regression models for each group, with the natural logarithm of the cost of the episode as the dependent variable, and predictor variables including the duration of the episode, duration squared, duration cubed and a variable indicating whether the episode was fatal. Visceral and CNS episodes were associated with higher costs than the other groups and were more likely to be shorter and fatal. A fatal recurrence of duration 15.7 months (the median for our sample) was predicted to cost $10,575 (Aus + 1988; or 4,877 pounds). Reduction of the substantial costs of recurrent breast cancer is likely to be a sizable economic benefit of adjuvant systemic therapy and mammographic screening. We did not identify any major opportunities for cost containment during the management of recurrences.

Full text

PDF
449

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bonadonna G., Valagussa P. Current status of adjuvant chemotherapy for breast cancer. Semin Oncol. 1987 Mar;14(1):8–22. [PubMed] [Google Scholar]
  2. Brewin T. B. The cancer patient--too many scans and X-rays? Lancet. 1981 Nov 14;2(8255):1098–1099. doi: 10.1016/s0140-6736(81)91288-5. [DOI] [PubMed] [Google Scholar]
  3. Ginzberg E. A hard look at cost containment. N Engl J Med. 1987 Apr 30;316(18):1151–1154. doi: 10.1056/NEJM198704303161811. [DOI] [PubMed] [Google Scholar]
  4. Goldhirsch A., Gelber R. D., Castiglione M. Relapse of breast cancer after adjuvant treatment in premenopausal and perimenopausal women: patterns and prognoses. J Clin Oncol. 1988 Jan;6(1):89–97. doi: 10.1200/JCO.1988.6.1.89. [DOI] [PubMed] [Google Scholar]
  5. Gray D., MacAdam D., Boldy D. A comparative cost analysis of terminal cancer care in home hospice patients and controls. J Chronic Dis. 1987;40(8):801–810. doi: 10.1016/0021-9681(87)90132-9. [DOI] [PubMed] [Google Scholar]
  6. Gray P. A., Abernethy M. A., Stoelwinder J. U. Models for costing patient care services. Part 2: Costing organ imaging services. Aust Health Rev. 1988;11(2):98–109. [PubMed] [Google Scholar]
  7. Gray P., Abernethy M., Stoelwinder J. Models for costing patient care services. Part 1: Costing diagnostic laboratory services. Aust Health Rev. 1987;10(2):69–88. [PubMed] [Google Scholar]
  8. Kamby C., Ejlertsen B., Andersen J., Birkler N. E., Rytter L., Zedeler K., Rose C. The pattern of metastases in human breast cancer. Influence of systemic adjuvant therapy and impact on survival. Acta Oncol. 1988;27(6A):715–719. doi: 10.3109/02841868809091774. [DOI] [PubMed] [Google Scholar]
  9. Langlands A. O., Pocock S. J., Kerr G. R., Gore S. M. Long-term survival of patients with breast cancer: a study of the curability of the disease. Br Med J. 1979 Nov 17;2(6200):1247–1251. doi: 10.1136/bmj.2.6200.1247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Long S. H., Gibbs J. O., Crozier J. P., Cooper D. I., Jr, Newman J. F., Jr, Larsen A. M. Medical expenditures of terminal cancer patients during the last year of life. Inquiry. 1984 Winter;21(4):315–327. [PubMed] [Google Scholar]
  11. Markman M. An argument in support of cost-effectiveness analysis in oncology. J Clin Oncol. 1988 Jun;6(6):937–939. doi: 10.1200/JCO.1988.6.6.937. [DOI] [PubMed] [Google Scholar]
  12. McArdle C. S., Calman K. C., Cooper A. F., Hughson A. V., Russell A. R., Smith D. C. The social, emotional and financial implications of adjuvant chemotherapy in breast cancer. Br J Surg. 1981 Apr;68(4):261–264. doi: 10.1002/bjs.1800680413. [DOI] [PubMed] [Google Scholar]
  13. Rees Gareth J. G. Cost-effectiveness in oncology. Lancet. 1985 Dec 21;2(8469-8470):1405–1408. [PubMed] [Google Scholar]
  14. Stoelwinder J. U., Stephenson L. G., Wallace P. G., Abernethy M. A., Putt C. M. Clinical costing at the Queen Victoria Medical Centre. Aust Health Rev. 1986;9(4):372–386. [PubMed] [Google Scholar]
  15. Tabár L., Fagerberg C. J., Gad A., Baldetorp L., Holmberg L. H., Gröntoft O., Ljungquist U., Lundström B., Månson J. C., Eklund G. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985 Apr 13;1(8433):829–832. doi: 10.1016/s0140-6736(85)92204-4. [DOI] [PubMed] [Google Scholar]
  16. Weinstein M. C. Methodologic issues in policy modeling for cardiovascular disease. J Am Coll Cardiol. 1989 Sep;14(3 Suppl A):38A–43A. doi: 10.1016/0735-1097(89)90160-5. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES