Cost effectiveness of bilateral risk-reducing mastectomy and salpingo-oophorectomy

Schrauder, Michael G.; Brunel-Geuder, Lisa; Häberle, Lothar; Wunderle, Marius; Hoyer, Juliane; Csorba, Roland; Reis, André; Schulz‐Wendtland, Rüdiger; Beckmann, Matthias W.; Lux, Michael P.

doi:10.1186/s40001-019-0391-8

Cited by 6 publications

(5 citation statements)

References 37 publications

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“…The reimbursement of prophylactic surgeries for BRCA -mutation carriers does often not cover the costs of executing hospitals in Germany [ 89 ]. There is a potential conflict of interest which may in the worst case impact the care and health benefit of BRCA -mutation carriers if this applies to Switzerland too.…”

Section: Discussionmentioning

confidence: 99%

Cost–utility analysis of risk-reducing strategies to prevent breast and ovarian cancer in BRCA-mutation carriers in Switzerland

et al. 2021

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Objective We aimed to identify the most cost-effective of all prophylactic measures available in Switzerland for women not yet affected by breast and ovarian cancer who tested positive for a BRCA1/2 mutation. Methods Prophylactic bilateral mastectomy (PBM), salpingo-oophorectomy (PBSO), combined PBM&PBSO and chemoprevention (CP) initiated at age 40 years were compared with intensified surveillance (IS). A Markov model with a life-long time horizon was developed from the perspective of the Swiss healthcare system using mainly literature-derived data to evaluate costs, quality-adjusted life years (QALYs) and survival. Costs and QALYs were discounted by 3% per year. Robustness of the results was tested with deterministic and probabilistic sensitivity analyses. Results All prophylactic measures were found to be cost-saving with an increase in QALYs and life years (LYs) compared to IS. PBM&PBSO were found to be most cost-effective and dominated all other strategies in women with a BRCA1 or BRCA2 mutation. Lifetime costs averaged to 141,293 EUR and 14.5 QALYs per woman with a BRCA1 mutation under IS, versus 76,639 EUR and 19.2 QALYs for PBM&PBSO. Corresponding results for IS per woman with a BRCA2 mutation were 102,245 EUR and 15.5 QALYs, versus 60,770 EUR and 19.9 QALYs for PBM&PBSO. The results were found to be robust in sensitivity analysis; no change in the dominant strategy for either BRCA-mutation was observed. Conclusion All more invasive strategies were found to increase life expectancy and quality of life of women with a BRCA1 or BRCA2 mutation and were cost-saving for the Swiss healthcare system compared to IS.

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Section: Discussionmentioning

confidence: 99%

Cost–utility analysis of risk-reducing strategies to prevent breast and ovarian cancer in BRCA-mutation carriers in Switzerland

et al. 2021

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“…For the second group, two surgical events are considered that have the purpose of removing the target organ, breasts, and/or ovaries, called risk-reducing mastectomy (RRM), in its contralateral or bilateral presentation; and risk-reducing bilateral salpingo-oophorectomy (RRBSO) [33,[53][54][55]. Both surgeries are cost-effective for long-term risk management [56][57][58].…”

Section: Effects On Quality Of Life In the Risk Care Of Patients Carr...mentioning

confidence: 99%

Quality of Life is Essential: Implications for Diagnosis and Treatment for BRCA1/2 Germline Mutations

Contreras¹,

Poveda²,

Gutierrez³

et al. 2023

BRCA1 and BRCA2 Mutations - Diagnostic and Therapeutic Implications

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BRCA1 and BRCA2 germline pathogenic variants are a matter of concern because of their relevance in cancer risk assessment, personalized treatment options, and cancer prevention. Therefore, the study of quality of life (QoL), although complex, has been a challenge for clinical care and research implications for patients and families with hereditary breast and ovarian cancer (HBOC). This chapter aims to show the evolution of the evaluation of the QoL study according to the current needs of patients with BRCA1/BRCA2 mutations.

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“…Risk-reducing surgeries can help prevent diseases and thus preserve health and result in additional life years in good health. Recognizing that these aspects of RRS are the most important, there are also data to suggest that RRS in BRCA-mutation carriers is cost effective compared to potentially avoidable cancer treatment costs [ 93 , 94 ]. Schrauder et al demonstrated that long-term health care costs can be reduced by RRS after genetic testing of BRCA mutation carriers in the German system.…”

Section: Prophylactic Surgerymentioning

confidence: 99%

Surgical Management of Hereditary Breast Cancer

Berger

Golshan

2021

Genes

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The identification that breast cancer is hereditary was first described in the nineteenth century. With the identification of the BRCA1 and BRCA 2 breast/ovarian cancer susceptibility genes in the mid-1990s and the introduction of genetic testing, significant advancements have been made in tailoring surveillance, guiding decisions on medical or surgical risk reduction and cancer treatments for genetic variant carriers. This review discusses various medical and surgical management options for hereditary breast cancers.

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Cost effectiveness of bilateral risk-reducing mastectomy and salpingo-oophorectomy

Cited by 6 publications

References 37 publications

Cost–utility analysis of risk-reducing strategies to prevent breast and ovarian cancer in BRCA-mutation carriers in Switzerland

Cost–utility analysis of risk-reducing strategies to prevent breast and ovarian cancer in BRCA-mutation carriers in Switzerland

Quality of Life is Essential: Implications for Diagnosis and Treatment for BRCA1/2 Germline Mutations

Surgical Management of Hereditary Breast Cancer

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