Patient‐level costs in margin re‐excision for breast‐conserving surgery

High rates of reoperation following breast‐conserving surgery (BCS) for positive margins are associated with costs to healthcare providers. The aim was to assess the quality of evidence on reported re‐excision costs and compare the direct patient‐level costs between patients undergoing successful BCS versus reoperations after BCS.

[1]  J. Hay,et al.  Examining the Value and Quality of Health Economic Analyses: Implications of Utilizing the QHES , 2003, Journal of managed care pharmacy : JMCP.

[2]  R. Aft,et al.  Cost Analysis of a Surgical Consensus Guideline in Breast-Conserving Surgery. , 2017, Journal of the American College of Surgeons.

[3]  Richard Sylvester,et al.  Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. , 2000, Journal of the National Cancer Institute.

[4]  S. Meijer,et al.  Ultrasound-guided surgery for palpable breast cancer is cost-saving: results of a cost-benefit analysis. , 2013, Breast.

[5]  E. Brown,et al.  Margins in breast conserving surgery: The financial cost & potential savings associated with the new margin guidelines. , 2016, Breast.

[6]  S. Steinberg,et al.  Eighteen‐year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy , 2003, Cancer.

[7]  M. Tan,et al.  The Value of Intraoperative Frozen Section Analysis for Margin Status in Breast Conservation Surgery in a Nontertiary Institution , 2014, International journal of breast cancer.

[8]  A. Wilson,et al.  Cosmesis and satisfaction after breast‐conserving surgery correlates with the percentage of breast volume excised , 2003, The British journal of surgery.

[9]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[10]  E. Bui,et al.  Intraoperative Assessment of Breast Cancer Specimens Decreases Cost and Number of Reoperations , 2011, The American surgeon.

[11]  B. Goh,et al.  Eighteen‐year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy , 2004, Cancer.

[12]  Ara Darzi,et al.  Diagnostic Accuracy of Intraoperative Techniques for Margin Assessment in Breast Cancer Surgery: A Meta-analysis , 2017, Annals of surgery.

[13]  B. E. F. Isher,et al.  Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. , 2002 .

[14]  D. Holmes,et al.  Analysis of the Impact of Intraoperative Margin Assessment with Adjunctive Use of MarginProbe versus Standard of Care on Tissue Volume Removed , 2012, International journal of surgical oncology.

[15]  C. Mackenzie,et al.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. , 1987, Journal of chronic diseases.

[16]  P. Macaskill,et al.  The Association of Surgical Margins and Local Recurrence in Women with Early-Stage Invasive Breast Cancer Treated with Breast-Conserving Therapy: A Meta-Analysis , 2014, Annals of Surgical Oncology.

[17]  Umberto Veronesi,et al.  Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. , 2002, The New England journal of medicine.

[18]  R E Pataky,et al.  Reoperation costs in attempted breast-conserving surgery: a decision analysis. , 2016, Current oncology.

[19]  B. Spiegel,et al.  The quality of published health economic analyses in digestive diseases: a systematic review and quantitative appraisal. , 2004, Gastroenterology.

[20]  Lajos Pusztai,et al.  A Randomized, Controlled Trial of Cavity Shave Margins in Breast Cancer. , 2015, The New England journal of medicine.

[21]  A. Lin,et al.  Impact of initial surgical margins and residual cancer upon re-excision on outcome of patients with localized breast cancer. , 2009, American journal of surgery.

[22]  A. Jager,et al.  Overall survival in patients with a re-excision following breast conserving surgery compared to those without in a large population-based cohort. , 2015, European journal of cancer.

[23]  T. Sarantou,et al.  Margin re‐excision and local recurrence in invasive breast cancer: A cost analysis using a decision tree model , 2015, Journal of surgical oncology.

[24]  H. Mouridsen,et al.  Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life-table analysis. Danish Breast Cancer Cooperative Group. , 1992, Journal of the National Cancer Institute. Monographs.

[25]  S. Morgan,et al.  Payers' experiences with confidential pharmaceutical price discounts: A survey of public and statutory health systems in North America, Europe, and Australasia. , 2017, Health policy.

[26]  J. Ferlay,et al.  Estimates of the cancer incidence and mortality in Europe in 2006. , 2006, Annals of oncology : official journal of the European Society for Medical Oncology.

[27]  A. Darzi,et al.  Rapid evaporative ionisation mass spectrometry of electrosurgical vapours for the identification of breast pathology: towards an intelligent knife for breast cancer surgery , 2017, Breast Cancer Research.

[28]  M. Trivella,et al.  Reoperation rates after breast conserving surgery for breast cancer among women in England: retrospective study of hospital episode statistics , 2012, BMJ : British Medical Journal.

[29]  R. Arriagada,et al.  Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group. , 1996, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[30]  A. Jager,et al.  Omitting re-excision for focally positive margins after breast-conserving surgery does not impair disease-free and overall survival , 2017, Breast Cancer Research and Treatment.

[31]  A. Degnim,et al.  Reasons for Re-Excision After Lumpectomy for Breast Cancer: Insight from the American Society of Breast Surgeons MasterySM Database , 2014, Annals of Surgical Oncology.

[32]  M. Bonzini,et al.  Cavity Shaving Reduces Involved Margins and Reinterventions Without Increasing Costs in Breast-Conserving Surgery: A Propensity Score-Matched Study , 2017, Annals of Surgical Oncology.

[33]  L. Newman,et al.  Development of an intraoperative pathology consultation service at a free-standing ambulatory surgical center: clinical and economic impact for patients undergoing breast cancer surgery. , 2012, American Journal of Surgery.

[34]  M. Golatta,et al.  Do Reexcisions Impair Aesthetic Outcome in Breast Conservation Surgery? Exploratory Analysis of a Prospective Cohort Study , 2012, Annals of Surgical Oncology.

[35]  G. Irwin,et al.  Current margin practice and effect on re-excision rates following the publication of the SSO-ASTRO consensus and ABS consensus guidelines: a national prospective study of 2858 women undergoing breast-conserving therapy in the UK and Ireland. , 2017, European journal of cancer.