Nav: Home

Reducing radiation could safely cut breast cancer treatment costs

March 14, 2017

DURHAM, N.C. - Over half of older women with early stage breast cancer received more radiation therapy than what might be medically necessary, adding additional treatment and health care costs, according to a study led by Duke Cancer Institute researchers.

The researchers found that the annual estimated cost for radiation therapy in women older than age 50 who were potentially eligible to cut back or eliminate the treatment was $420.2 million in 2011. Had this group of women been treated with the alternative approaches that evidence suggests are as effective, the cost was estimated at $256.2 million - a potential savings of $164 million.

"It's important to look for opportunities in cancer treatment where we can safely reduce health care costs without compromising excellent outcomes," said Rachel A. Greenup, M.D., assistant professor of surgery and lead author of a study published March 14 in the Journal of Oncology Practice.

"Our study provides an example of a win-win situation, where patients can receive high-quality, evidence-based cancer care while also reducing the treatment burden for patients and the health care system," Greenup said.

Greenup and colleagues, including senior author E. Shelley Hwang, M.D., chief of breast surgery at the Duke Cancer Institute, used 2011 data from the National Cancer Database to identify more than 43,000 breast cancer patients aged 50 and older. All had small tumors that had not spread to the lymph nodes, and had been treated with lumpectomy.

Previous studies have shown that these patients can do equally well when treated with a four-week course of breast radiation, as opposed to the traditional six-week regimen. An additional study demonstrated that carefully selected patients aged 70 and older had no additional survival benefit with radiation therapy when treated with tamoxifen after lumpectomy.

Despite the published evidence, however, the Duke-led researchers found that 57 percent of patients who were potentially eligible to reduce or forego radiation still received the longer, costlier regimens.

Using Medicare reimbursement data, the researchers estimated that the cost per patient for the conventional, six-week radiation therapy was more than $13,000. That compared to a little more than $8,000 for the shorter regimen or no cost when radiation is eliminated.

Greenup said the financial analysis of cost savings in the study was limited because Medicare data do not provide as much information as insurance data, which were not available for this study. Additionally, she said, the available patient data do not provide reasons why women underwent the longer, costlier radiation treatments. In many instances, the treatment might have been warranted based on factors that were not evident in the database, or patients might have been uncomfortable reducing or omitting radiation.

Greenup said the study nonetheless highlights the need to apply evolving evidence to treatment decisions.

"Breast cancer treatment costs are projected to reach $20 billion in 2020," Greenup said, citing National Cancer Institute statistics. "Of course high-quality care is the priority in cancer treatment, but our study suggests that utilization of evidence-based radiation treatment can translate into reductions in health care spending without sacrificing quality."
-end-
In addition to Greenup and Hwang, study authors include Rachel C. Blitzblau, Kevin L. Houck, Julie Ann Sosa, Janet Horton, Jeffrey M. Peppercorn, Alphonse G. Taghian, and Barbara L. Smith.

The study received funding support from the Building Interdisciplinary Research in Women's Health award from Duke.

Duke University Medical Center

Related Radiation Therapy Articles:

Radiation therapy, macrophages improve efficacy of nanoparticle-delivered cancer therapy
Massachusetts General Hospital investigators report finding finding how appropriately timed radiation therapy can significantly improve the delivery of cancer nanomedicines by attracting macrophages to tumor blood vessels, which results in a transient 'burst' of nanoencapsulated drugs from capillaries into the tumor.
Moffitt improves radiation therapy for head and neck patients
The researchers are able to use the radiosensitivity index within a mathematical framework to select the optimum radiotherapy dose for each patient based on their individual tumor biology.
As radiation therapy declined so did second cancers in childhood cancer survivors
Childhood cancer survivors are living longer. Now research shows they are also less likely to develop second cancers while still young.
Conventional radiation therapy may not protect healthy brain cells
A new study shows that repeated radiation therapy used to target tumors in the brain may not be as safe to healthy brain cells as previously assumed.
Does radiation therapy improve survival for women with ductal carcinoma in situ?
Investigators from Brigham and Women's Hospital (BWH) and the Dana-Farber Cancer Institute have found that a set of easily measurable risk factors can predict the magnitude of survival benefit offered by radiation therapy following breast cancer surgery.
Recommendation to omit radiation therapy after lumpectomy is not frequently implemented
Nearly two-thirds of US women age 70 or older with stage I breast cancer who undergo lumpectomy and are eligible to safely omit subsequent radiation therapy according to national cancer guidelines still receive this treatment, according to new study results.
New paste prevents scarring caused by radiation therapy for cancer
An antiscarring paste when applied to the skin of mice halts fibrosis caused by the radiation used in cancer therapy.
Cherenkov Effect improves radiation therapy for patients with cancer
The characteristic blue glow from a nuclear reactor is present in radiation therapy, too.
Clinical trial shows benefits of animal-assisted therapy in adult cancer patients undergoing complex cancer treatment with chemotherapy and radiation therapy
Therapy dogs may improve the emotional well-being of some cancer patients, according to results of a clinical study, the first to document the benefits of animal-assisted therapy in adult cancer patients.
Medication does not help prevent ED following radiation therapy for prostate cancer
Among men undergoing radiation therapy for prostate cancer, daily use of the erectile dysfunction drug tadalafil, compared with placebo, did not prevent loss of erectile function, according to a study in the April 2 issue of JAMA.

Related Radiation Therapy Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Bias And Perception
How does bias distort our thinking, our listening, our beliefs... and even our search results? How can we fight it? This hour, TED speakers explore ideas about the unconscious biases that shape us. Guests include writer and broadcaster Yassmin Abdel-Magied, climatologist J. Marshall Shepherd, journalist Andreas Ekström, and experimental psychologist Tony Salvador.
Now Playing: Science for the People

#514 Arctic Energy (Rebroadcast)
This week we're looking at how alternative energy works in the arctic. We speak to Louie Azzolini and Linda Todd from the Arctic Energy Alliance, a non-profit helping communities reduce their energy usage and transition to more affordable and sustainable forms of energy. And the lessons they're learning along the way can help those of us further south.