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Cost comparison of axillary sentinel lymph node detection and axillary lymphadenectomy in early breast cancer. A national study based on a prospective multi-institutional series of 985 patients 'on behalf of the Group of Surgeons from the French Unicancer Federation'.
- Source :
-
Annals of oncology : official journal of the European Society for Medical Oncology [Ann Oncol] 2012 May; Vol. 23 (5), pp. 1170-1177. Date of Electronic Publication: 2011 Sep 06. - Publication Year :
- 2012
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Abstract
- Background: Our objective was to assess the global cost of the sentinel lymph node detection [axillary sentinel lymph node detection (ASLND)] compared with standard axillary lymphadenectomy [axillary lymph node dissection (ALND)] for early breast cancer patients.<br />Patients and Methods: We conducted a prospective, multi-institutional, observational, cost comparative analysis. Cost calculations were realized with the micro-costing method from the diagnosis until 1 month after the last surgery.<br />Results: Eight hundred and thirty nine patients were included in the ASLND group and 146 in the ALND group. The cost generated for a patient with an ASLND, with one preoperative scintigraphy, a combined method for sentinel node detection, an intraoperative pathological analysis without lymphadenectomy, was lower than the cost generated for a patient with lymphadenectomy [€ 2947 (σ = 580) versus € 3331 (σ = 902); P = 0.0001].<br />Conclusion: ASLND, involving expensive techniques, was finally less expensive than ALND. The length of hospital stay was the cost driver of these procedures. The current observational study points the heterogeneous practices for this validated and largely diffused technique. Several technical choices have an impact on the cost of ASLND, as intraoperative analysis allowing to reduce rehospitalization rate for secondary lymphadenectomy or preoperative scintigraphy, suggesting possible savings on hospital resources.
- Subjects :
- Aged
Algorithms
Axilla pathology
Breast Neoplasms diagnosis
Breast Neoplasms surgery
Carcinoma diagnosis
Carcinoma surgery
Costs and Cost Analysis
Disease Progression
Female
France
General Surgery organization & administration
Humans
Length of Stay economics
Length of Stay statistics & numerical data
Lymph Node Excision methods
Lymph Nodes pathology
Lymph Nodes surgery
Lymphatic Metastasis diagnosis
Medical Oncology organization & administration
Middle Aged
Neoplasm Staging economics
Prospective Studies
Societies, Medical
Breast Neoplasms economics
Breast Neoplasms pathology
Carcinoma economics
Carcinoma pathology
Lymph Node Excision economics
Sentinel Lymph Node Biopsy economics
Subjects
Details
- Language :
- English
- ISSN :
- 1569-8041
- Volume :
- 23
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Annals of oncology : official journal of the European Society for Medical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 21896543
- Full Text :
- https://doi.org/10.1093/annonc/mdr355