Asymptomatic women who have been treated for early-stage breast cancer often undergo advanced imaging and other tests that add cost but not value, according to a Fred Hutch study that will be presented at the American Society of Clinical Oncology annual meeting in Chicago.
ASCO Choosing Wisely guidelines recommend against the routine use of advanced imaging scans and costly blood tests to track tumour markers in women with early-stage breast cancer. The reason: Several studies have shown there is no benefit for these patients, and false-positive results can lead to unnecessary procedures, unneeded radiation exposure, misdiagnosis and possible overtreatment.
Analysis of records of 2,193 early-stage breast cancer patients however found that 37 percent received tumour-marker tests during the post-treatment surveillance period, averaging 2.8 tests per patient, and 17 percent received advanced imaging, averaging 1.5 images per patient. The study showed that costs for patients undergoing these advanced procedures were considerably higher than the average $18,403 during the surveillance period.
“During early surveillance following treatment, patients averaged 13.3 physician visits, primarily with oncologists and primary care providers. We believe one of the best ways we can help patients reduce their financial burden is for us to reinforce the message with oncologists that these tests have been shown to provide no benefit for this particular group of patients,” said Dr. Gary Lyman, a breast cancer oncologist, health economist and co-director of the Hutchinson Institute for Cancer Outcomes Research (HICOR), who was a study leader.
The study linked cancer registry patient records in western Washington with claims from the commercial insurers Premera and Regence.
Dr. Lyman will present the findings in a poster presentation, “Patterns in provider types and cost of surveillance testing in early-stage breast cancer patients: a regional study,” developed with contributions from the HICOR team, including Catherine Fedorenko, Julia Rose Walker and Karma Kreizenbeck.
Source: Fred Hutchinson Cancer Research Center
Image Credit: Bo Jungmayer/Fred Hutch News Service
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breast cancer, Inappropriate Testing, Asymptomatic women, early-stage breast cancer
Asymptomatic women who have been treated for early-stage breast cancer often undergo advanced imaging and other tests that add cost but not value, according to a Fred Hutch study
