BackgroundIn recent years, cases of breast cancer have been on the rise in Vietnam. To date, there has been no study on the financial burden of the disease. This study estimates the direct medical cost of a 5-year treatment course for women with primary breast cancer in central Vietnam.MethodsRetrospective patient-level data from medical records at the Hue Central Hospital between 2001 and 2006 were analyzed. Cost analysis was conducted from the health care payers’ perspective. Various direct medical cost categories were computed for a 5-year treatment course for patients with breast cancer. Costs, in US dollars, discounted at a 3% rate, were converted to 2010 after adjusting for inflation. For each cost category, the mean, standard deviation, median, and cost range were estimated. Median regression was used to investigate the relationship between costs and the stage, age at diagnosis, and the health insurance coverage of the patients.ResultsThe total direct medical cost for a 5-year treatment course for breast cancer in central Vietnam was estimated at $975 per patient (range: $11.7–$3,955). The initial treatment cost, particularly the cost of chemotherapy, was found to account for the greatest proportion of total costs (64.9%). Among the patient characteristics studied, stage at diagnosis was significantly associated with total treatment costs. Patients at later stages of breast cancer did not differ significantly in their total costs from those at earlier stages however, but their survival time was much shorter. The absence of health insurance was the main factor limiting service uptake.ConclusionFrom the health care payers’ perspective, the Government subsidization of public hospital charges lowered the direct medical costs of a 5-year treatment course for primary breast cancer in central Vietnam. However, the long treatment course was significantly influenced by out-of-pocket payments for patients without health insurance.

Vietnamese and Chinese women with hormone receptor-positive operable breast cancer benefit from adjuvant treatment with surgical oophorectomy and tamoxifen.

In premenopausal women with operable breast cancer not selected for estrogen receptor status or with estrogen receptor-positive tumors, 5- and 10-year DFS and OS rates are significantly improved following adjuvant oophorectomy and tamoxifen.

The hypothesized benefit of adjuvant luteal phase oophorectomy was not shown in this large trial.

Abstract:The objective of this study was to observe the combustion process of extracted rapeseed (ER) grist in a stationary fluidized bed combustor (SFBC) and evaluate the chemical compositions of the flue gas emissions. The experimental tests of ER combustion in the 90 to 200 kW (Kilowatt) SFB combustion test facility show that the optimal ER combustion temperature is within the range from 850 to 880° C. Temperature and the concentration of exhausted emissions (e.g. O 2 , CO, CO 2 , NO, NO 2 , SO 2 , C org ) were measured with dedicated sensors distributed within the combustor, along its height and in the flue gas duct. The experimental results showed that with respect to German emission limits the concentration of SO 2 and NO x in the flue gas were high whereas that of CO was low. This study furthermore is applicable for the abundant biomass residue resources in Vietnam (rice husk, rice straw, bagasse, cassava residues, coconut shell etc.), which have similar chemical compositions to ER.