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Budget Impact Analysis of Preoperative Radioactive Seed Localization.

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Radioactive seed localization (RSL) is more expensive than wire-guided localization (WGL) for nonpalpable breast lesions. Manually loading seeds may offer cost savings for RSL programs.

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Area of Science:

  • Medical Economics
  • Surgical Oncology
  • Radiology

Background:

  • Nonpalpable breast lesions require localization before surgical removal.
  • Wire-guided localization (WGL) is a traditional method.
  • Radioactive seed localization (RSL) is an emerging alternative.

Purpose of the Study:

  • To model the costs of implementing an RSL program.
  • To compare the costs of RSL versus WGL at a Canadian tertiary hospital.
  • To identify cost-saving strategies for RSL.

Main Methods:

  • Retrospective review of patient data and costs (Jan 2014-Dec 2016).
  • Budget impact and sensitivity analyses performed.
  • Calculated mean, minimum, and maximum costs per lesion, operational, and initial costs.

Main Results:

  • Mean cost per localization: $185 CAD for WGL vs. $283 CAD for RSL (preloaded seeds).
  • Annual operational expenditure: $49,835 for WGL vs. $80,803 for RSL.
  • Initial RSL costs: $22,000 (training, equipment).

Conclusions:

  • RSL with preloaded seeds is more costly than WGL due to per-lesion costs and radiation safety measures.
  • Manually loading radioactive seeds presents a potential cost-saving alternative.
  • Cost breakdown provides a framework for other centers to evaluate localization methods.