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Economic Impact of Reducing Reexcision Rates after Breast-Conserving Surgery in a Large, Integrated Health System.

Jeffery M Chakedis1, Annie Tang2, Alison Savitz1

  • 1Department of General Surgery, The Permanente Medical Group (TPMG), Oakland, CA, USA.

Annals of Surgical Oncology
|July 29, 2022
PubMed
Summary
This summary is machine-generated.

Reexcision after breast-conserving surgery (BCS) significantly increases healthcare costs and operating room (OR) time. Reducing reexcision rates could yield substantial savings in both cost and time.

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Area of Science:

  • Oncology
  • Health Economics
  • Surgical Outcomes

Background:

  • Breast-conserving surgery (BCS) is a common treatment for breast cancer.
  • Reexcision following BCS incurs significant costs for patients and healthcare systems.
  • Limited data exists on the economic burden of reexcision on healthcare systems.

Purpose of the Study:

  • To quantify the operating room (OR) charges and time associated with reexcision after BCS.
  • To model the potential cost and OR time savings from a reexcision reduction initiative.

Main Methods:

  • Retrospective cohort review of breast cancer patients undergoing BCS from January 1, 2016, to December 31, 2020.
  • Calculation of OR charges for disposable supplies and implants.
  • Analysis of operative time for reexcision procedures.

Main Results:

  • 18.5% of 8804 BCS patients required reexcision.
  • Reexcision accounted for 39% of total direct OR costs and 14% of total OR time.
  • A simulated initiative to reduce reexcision rates to below 20% predicted an 18% decrease in operations, 14% reduction in OR costs, and 11% reduction in OR time.

Conclusions:

  • Reexcision after BCS represents a substantial portion of direct OR costs and time.
  • Targeted improvements in surgeon reexcision rates can lead to significant economic and operational efficiencies.
  • Reducing reexcision rates is a viable strategy for healthcare cost containment in breast cancer surgery.