MAST + RECON

Study looks at factors such as cost, complications

BY Laura Sussman

An MD Anderson study of guideline-concordant treatments for women with early-stage breast cancer found that mastectomy plus reconstruction (mast+recon) not only is the most expensive option in a younger patient population but also has the highest rate of complications and complication-related costs, regardless of age.

The findings, presented in December at the 2015 San Antonio Breast Cancer Symposium by Benjamin Smith, M.D., associate professor, Radiation Oncology and Health Services Research, should help guide patients and help physicians determine the most appropriate treatment options, as well as help define which local therapies offer the highest value to patients and payers.

Over the past decade, the rate of mast+recon has risen in the United States. This study is the first to quantify the harm associated with this trend, says Smith.

"What we show for the first time is that while the patient is undergoing more surgery, she is also taking on a considerable amount of risk with regard to what could happen," he says.

Cost data, from 2010 and 2011, indicated the average insurance company of patients who chose mast+recon pays approximately $10,000 over two years to manage the complications of that procedure. Smith stresses that these findings should not be used to decrease reimbursement or coverage for mast+recon when medically indicated.

This study was funded by grants from the Department of Health Services, Varian Medical Systems and the Duncan Family Foundation.

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