Cost of contralateral prophylactic mastectomy.

Area of Science:

• Oncology
• Health Economics
• Surgical Outcomes

Background:

• Unilateral breast cancer treatment decisions involve complex factors.
• Contralateral prophylactic mastectomy (CPM) is a surgical option for women with unilateral breast cancer.
• Understanding the economic impact of CPM is crucial for patient and provider decision-making.

Purpose of the Study:

• To compare the short-term healthcare costs associated with contralateral prophylactic mastectomy (CPM) versus no CPM in women diagnosed with unilateral breast cancer.
• To quantify the financial implications of CPM on total breast cancer care expenditures.

Main Methods:

• Retrospective analysis of 904 women with stage I-III breast cancer, matched for key demographic and clinical factors.
• Healthcare costs were tracked for 24 months post-surgery, distinguishing between immediate and delayed CPM.
• Costs were standardized to Medicare reimbursement values and adjusted for inflation; multivariable regression analyzed CPM's impact.

Main Results:

• Contralateral prophylactic mastectomy (CPM) was associated with a statistically significant 16.9% increase in mean total healthcare costs compared to the no-CPM group.
• Mean total cost differences were $7,749 for CPM versus no CPM, with immediate CPM costing $6,528 more and delayed CPM costing $16,744 more.
• Factors like HER2/neu-positive status, radiation, and reconstruction also correlated with increased total costs.

Conclusions:

• Contralateral prophylactic mastectomy (CPM) substantially elevates short-term healthcare expenditures for women with unilateral breast cancer.
• The findings provide essential patient-level cost data to inform future research on CPM's role in treatment decision-making.