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Economic outcomes of breast cancer survivorship: CALGB study 79804

Breast Cancer Research and Treatment volume 91, pages 153–161 (2005)Cite this article

Abstract

Background. Over 80 of women diagnosed with breast cancer will be survivors. We sought to determine the economic consequences of surviving breast cancer.

Methods. Disease-free survivors who had received adjuvant chemotherapy for stage II breast cancer on CALGB study 8541 participated in a study of long-term outcomes. Survey responses were used to determine the types and frequency of medical resources used in follow-up, annual direct medical costs, and survivor perceptions of the personal economic impact of breast cancer.

Results. 245 of 314 (78%) invited breast cancer survivors (median follow-up 12.2 years, range 9.3–16.4) completed the surveys. Eighty-seven percent reported having cancer specialist follow-up in the past year. The following percentages of survivors reported having had, for breast cancer follow-up, at least once in the past year: breast examination 92%, mammogram 88, bone scan 18%, chest radiograph 59%, tumor marker studies 37%. When follow-up care included a medical oncologist, resources were more likely to be used at least according to published follow-up guidelines, or over-used. Median annual cost of follow-up per survivor was $630 (range $0–10,817) with higher costs associated with medical oncology follow-up, lower income, and younger age. Few women reported a negative impact of breast cancer on employment, but 16% reported being denied life insurance.

Conclusions. Among long-term breast cancer survivors, patient self-report data suggest that over-use of medical resources for follow-up appears common. When follow-up care included a medical oncologist, resources were more likely to be used appropriately, or over-used. Costs of follow-up are higher with medical oncology follow-up, lower income and among younger survivors. The annual cost of follow-up varies widely and may be driven by over-use of follow-up tests.

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Affiliations

  1. Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA

    Martee L. Hensley

  2. CALGB Statistical Center, Durham, NC, USA

    Jeannette Dowell & James E. Herndon II

  3. Dana Farber Cancer Institute, Boston, MA, USA

    Eric Winer & Jane C. Weeks

  4. Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Nancy Stark

  5. The Ohio State University Medical Center, Columbus, OH, USA

    Electra Paskett

Authors
  1. Martee L. Hensley
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  2. Jeannette Dowell
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  3. James E. Herndon II
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  4. Eric Winer
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  5. Nancy Stark
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  6. Jane C. Weeks
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  7. Electra Paskett
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Correspondence to Martee L. Hensley.

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Hensley, M.L., Dowell, J., Herndon, J.E. et al. Economic outcomes of breast cancer survivorship: CALGB study 79804. Breast Cancer Res Treat 91, 153–161 (2005). https://doi.org/10.1007/s10549-004-6497-9

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  • DOI: https://doi.org/10.1007/s10549-004-6497-9

Keywords

  • breast carcinoma
  • costs and cost analyses
  • outcomes assessment
  • survivors