Self-Reported Risk Factors for Financial Distress and Attitudes Regarding Cost Discussions in Cancer Care: A Single-Institution Cross-Sectional Pilot Study of Breast Reconstruction Recipients

Abstract

Breast cancer management has witnessed major advances over the past several years that have translated into significant gains in life expectancy and improved survival. 1 Moreover, reconstruction following primary tumor extirpation has been associated with improved patient satisfaction and body image and better quality of life. 2-4 However, these technological enhancements in cancer care have attendant high costs to patients, their families, and society. In 2010, the cost of care of breast cancer was among

Predictors of surgery choices in women with early-stage breast cancer in China: a retrospective study

“…Women with greater out-of-pocket medical expenses may go into debt if they opt for breast reconstruction surgery [ 29 ]. Additionally, there is a connection between a breast cancer diagnosis and a reduction in income caused by a reduction in working hours, which increases economic pressure on the patient and their family [ 30 ]. These factors inhibit and may prohibit self-paying women from being able to consider breast reconstruction procedures.…”

Impact of High-Deductible Health Plans on Breast Reconstruction: Considerations for Financial Toxicity

“…Recent studies on financial toxicity focus on a lack of provider engagement in the financial aspects of treatment. 11 For example, 73% of breast cancer patients surveyed, 18 who expressed financial concern about treatment, felt that their providers did not address cost issues related to their cancer care. For women and surgeons concerned about financial toxicity related to breast reconstruction, the present data provide real-world numbers of the U.S. commercially insured population for comparison and planning.…”

Financial Toxicity Following Post-Mastectomy Reconstruction: Consideration for a Novel Outcome Measure

“…The current study entitled, 'Financial Toxicity in Breast Reconstruction: A National Survey of Women Who Have Undergone Breast Reconstruction After Mastectomy', builds upon preliminary works in this area. [11][12][13] Using a 33-item survey administered to the Love Research Army, the authors aimed to evaluate whether patients experience FT attributable to breast reconstruction and to identify predictors. There were 922 respondents who were at least 1 year following postmastectomy breast reconstruction.…”

“…income level, credit score, marital status) in the SDM process. 11 Cost conversations could easily begin, with plastic surgeons engaging patients in discussion about whether or not they have a high versus low deductible health care plan as this will likely impact patient OOP expenses. Second, it is also concordant with the finding by Greenup et al that among women with an income \$45,000, treatment cost considerations were ranked as more important than breast reconstruction or preservation.…”

“…12 Undoubtedly, addressing FT will require multi-level policy solutions that are beyond the scope of the present editorial and range from improving financial literacy (patient-level), to embedding financial navigators within breast cancer clinics (institution-level), to de-escalating the provision of low-value services (surgeon-level). 11 Highlighting the high prevalence (23.8%) and considerable sequelae of FT in breast reconstruction (i.e. decision regret, worse quality-oflife) is a crucial component of any meaningful effort.…”