Decision-Analytic Model and Cost-Effectiveness Evaluation of Postmastectomy Radiation Therapy in High-Risk Premenopausal Breast Cancer Patients

Lee, Jason H.; Glick, Henry A.; Hayman, James A.; Solin, Lawrence J.

doi:10.1200/jco.2002.07.008

Cited by 50 publications

(30 citation statements)

References 62 publications

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“…This rate was estimated for women under age 50 years, and stratified by nodal status (negative, positive) and time since randomization (first five years, second five years). Since the overview data cover only a 10-year period, we assumed a continuing decline in the underlying rate of recurrence in subsequent years, consistent with assumptions used in prior decision analyses [25,26].…”

Section: Natural Historymentioning

confidence: 96%

Adjuvant Ovarian Suppression Versus Chemotherapy for Premenopausal, Hormone-responsive Breast Cancer: Quality of Life and Efficacy Tradeoffs

Elkin

Weinstein²,

Kuntz³

et al. 2005

Breast Cancer Res Treat

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Section: Natural Historymentioning

confidence: 96%

Adjuvant Ovarian Suppression Versus Chemotherapy for Premenopausal, Hormone-responsive Breast Cancer: Quality of Life and Efficacy Tradeoffs

Elkin

Weinstein²,

Kuntz³

et al. 2005

Breast Cancer Res Treat

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“…As early recurrence typically portends a worse prognosis, the annual probabilities of distant disease and death in the model were greater in the first five years, in comparison with subsequent years. For death from breast cancer, annual probabilities were 0.50 in the first year, 0.41 in the second, 0.32 in the third, fourth and fifth, and 0.22 from the sixth year onwards 23 . The annual probabilities of distant disease after local recurrence derived from the curve presented by Kamby and Sengelov 24 .…”

Section: Probabilitiesmentioning

confidence: 98%

Cost-effectiveness of anastrozole, in comparison with tamoxifen, in the adjuvant treatment of early breast cancer in Brazil

Fonseca

Araújo²,

Saad³

2009

Rev. Assoc. Med. Bras.

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Summary objectIve. Breast cancer, a leading type of cancer in many developing countries, is the most frequent non-cutaneous tumor in Brazil. Hormone therapy is the standard of care in the adjuvant treatment of early-stage, hormone-receptor-positive disease, and both tamoxifen and third-generation aromatase inhibitors are options in postmenopausal women. The comparative cost-effectiveness of different treatment strategies is of considerable interest in societies facing limited resources. Methods.In an attempt to compare cost-effectiveness of upfront treatment with tamoxifen or anastrozole, the medical and economic results in a hypothetical cohort of 64-year-old postmenopausal women, was analyzed considering the Brazilian healthcare system in 2005, the primary perspective of the private sector, and a lifetime horizon. Data from the ATAC Trial, Markov modeling, a modified Delphi panel, and microcosting (in Brazilian R$) were used to estimate costs and effectiveness of the two upfront strategies. results. The model estimated a gain of 0.55 discounted life-years for patients receiving anastrozole, relative to those treated with tamoxifen. With an incremental cost of R$ 15,141.15, the model estimated that the cost-effectiveness of anastrozole, in relation to tamoxifen, was R$ 27,326.80. Monte Carlo simulations showed that approximately 50% of the cases fell below the threshold of R$ 29,229.00 per life-year gained, which is recommended by the World Health Organization for Brazil. conclusIon. It was concluded that upfront anastrozole is a cost-effective option compared with tamoxifen in the adjuvant treatment of postmenopausal women with hormone-receptor-positive early breast cancer.

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“…Among all cancers, breast cancer is the most frequently diagnosed in women 2 . It is estimated that each year are occurring more than 1 050 000 new cases of breast cancer worldwide 3 .…”

Section: Introductionmentioning

confidence: 99%

Education and cancer prevention: knowledge of brazilian students about breast cancer. Lagarto, Brazil, 2014

Kameo

Silva

Neves

et al. 2016

revmed

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Introduction: breast cancer is the leading cause of death among Brazilian women, 57 120 new cases are expected in 2015. Therefore, there is the need for strategic actions aimed at prevention and early diagnosis. Health education is an action directed on the knowledge of people, and this process helps to reduce cancer morbidity and mortality statistics. Objective: to identify the knowledge level of students in relation to breast cancer, its risk factors and how to prevent them. Material and methods: this is a quantitative, descriptive and exploratory research. Healthcare academics at Federal University of Sergipe conducted a presentation targeted to high school students from public schools, dramatizing real situations, emphasizing prevention and early diagnosis of breast cancer, and after that, they performed data collection using a questionnaire related to breast cancer prevention. Ethical issues were followed according to Resolution 466/12 of the National Health Council. Results: the sample consisted of 185 students, mostly female, between 18 to 20 years old, attending high school. In the last three years, 80.5% reported having received information on breast cancer; 53% received information on breast self-examination. Even after receiving knowledge about the prevention of breast cancer, 61.1% did not perform the breast self-examination; among the ones who did it, 64.9% did not find changes in the breast. Knowledge and awareness of women about breast cancer seem to be related to the delay in diagnosis and also in adherence to screening practices. Conclusion: most people received information about breast cancer, but do not use it correctly. Even though not being able to change some risk factors such as age and family history, the information about prevention is useful for women to know their risks and can take a conscious attitude to early detection. MÉD UIS. 2016;29(1):37-44.

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Decision-Analytic Model and Cost-Effectiveness Evaluation of Postmastectomy Radiation Therapy in High-Risk Premenopausal Breast Cancer Patients

Abstract: This analysis suggests that PMRT offers substantial clinical benefits achieved in a cost-effective manner, with an average cost per year of life gained of $24,900. Results of the model were robust under a wide range of clinical and economic parameters.

Cited by 50 publications

References 62 publications

Adjuvant Ovarian Suppression Versus Chemotherapy for Premenopausal, Hormone-responsive Breast Cancer: Quality of Life and Efficacy Tradeoffs

Adjuvant Ovarian Suppression Versus Chemotherapy for Premenopausal, Hormone-responsive Breast Cancer: Quality of Life and Efficacy Tradeoffs

Cost-effectiveness of anastrozole, in comparison with tamoxifen, in the adjuvant treatment of early breast cancer in Brazil

Education and cancer prevention: knowledge of brazilian students about breast cancer. Lagarto, Brazil, 2014

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