Does the breast cancer dollar make sense?

The past decade has witnessed a transformation of breast cancer management. Innovative developments such as widespread mammographic screening, breast-conserving approaches to primary disease and adjuvant systemic therapy have improved the quality of breast cancer care in the community. These and other therapeutic developments have been accompanied by substantial increases in consumption of health care resources. With the exception of adjuvant systemic therapy for node-positive disease, the evidence that such increases have been associated with commensurate improvements in disease outcome is weak. Indefinite continuation of this trend may prove incompatible with socioeconomic realities.