Cost comparison of axillary sentinel lymph node detection and axillary lymphadenectomy in early breast cancer. A national study based on a prospective multi-institutional series of 985 patients ‘on behalf of the Group of Surgeons from the French Unicancer Federation’
Our objective was to assess the global cost of the sentinel lymph node detection [axillary sentinel lymph node detection (ASLND)] compared with standard axillary lymphadenectomy [axillary lymph node dissection (ALND)] for early breast cancer patients. We conducted a prospective, multi-institutional,...
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| Veröffentlicht in: | Annals of oncology 2012-05, Vol.23 (5), p.1170-1177 |
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| creator | Classe, J.M. Baffert, S. Sigal-Zafrani, B. Fall, M. Rousseau, C. Alran, S. Rouanet, P. Belichard, C. Mignotte, H. Ferron, G. Marchal, F. Giard, S. Tunon de Lara, C. Le Bouedec, G. Cuisenier, J. Werner, R. Raoust, I. Rodier, J.-F. Laki, F. Colombo, P.-E. Lasry, S. Faure, C. Charitansky, H. Olivier, J.-B. Chauvet, M.-P. Bussières, E. Gimbergues, P. Flipo, B. Houvenaeghel, G. Dravet, F. Livartowski, A. |
| description | Our objective was to assess the global cost of the sentinel lymph node detection [axillary sentinel lymph node detection (ASLND)] compared with standard axillary lymphadenectomy [axillary lymph node dissection (ALND)] for early breast cancer patients.
We conducted a prospective, multi-institutional, observational, cost comparative analysis. Cost calculations were realized with the micro-costing method from the diagnosis until 1 month after the last surgery.
Eight hundred and thirty nine patients were included in the ASLND group and 146 in the ALND group. The cost generated for a patient with an ASLND, with one preoperative scintigraphy, a combined method for sentinel node detection, an intraoperative pathological analysis without lymphadenectomy, was lower than the cost generated for a patient with lymphadenectomy [€2947 (σ = 580) versus €3331 (σ = 902); P = 0.0001].
ASLND, involving expensive techniques, was finally less expensive than ALND. The length of hospital stay was the cost driver of these procedures. The current observational study points the heterogeneous practices for this validated and largely diffused technique. Several technical choices have an impact on the cost of ASLND, as intraoperative analysis allowing to reduce rehospitalization rate for secondary lymphadenectomy or preoperative scintigraphy, suggesting possible savings on hospital resources. |
| doi_str_mv | 10.1093/annonc/mdr355 |
| format | Article |
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We conducted a prospective, multi-institutional, observational, cost comparative analysis. Cost calculations were realized with the micro-costing method from the diagnosis until 1 month after the last surgery.
Eight hundred and thirty nine patients were included in the ASLND group and 146 in the ALND group. The cost generated for a patient with an ASLND, with one preoperative scintigraphy, a combined method for sentinel node detection, an intraoperative pathological analysis without lymphadenectomy, was lower than the cost generated for a patient with lymphadenectomy [€2947 (σ = 580) versus €3331 (σ = 902); P = 0.0001].
ASLND, involving expensive techniques, was finally less expensive than ALND. The length of hospital stay was the cost driver of these procedures. The current observational study points the heterogeneous practices for this validated and largely diffused technique. Several technical choices have an impact on the cost of ASLND, as intraoperative analysis allowing to reduce rehospitalization rate for secondary lymphadenectomy or preoperative scintigraphy, suggesting possible savings on hospital resources.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mdr355</identifier><identifier>PMID: 21896543</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Aged ; Algorithms ; Antineoplastic agents ; Axilla - pathology ; axillary lymphadenectomy ; Biological and medical sciences ; breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - economics ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Carcinoma - diagnosis ; Carcinoma - economics ; Carcinoma - pathology ; Carcinoma - surgery ; cost ; Costs and Cost Analysis ; Disease Progression ; Female ; France ; General Surgery - organization & administration ; Gynecology. Andrology. Obstetrics ; Humans ; Length of Stay - economics ; Length of Stay - statistics & numerical data ; Lymph Node Excision - economics ; Lymph Node Excision - methods ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Lymphatic Metastasis - diagnosis ; Mammary gland diseases ; Medical Oncology - organization & administration ; Medical sciences ; Middle Aged ; Neoplasm Staging - economics ; Original ; Pharmacology. Drug treatments ; Prospective Studies ; sentinel lymph node ; Sentinel Lymph Node Biopsy - economics ; Societies, Medical ; Tumors</subject><ispartof>Annals of oncology, 2012-05, Vol.23 (5), p.1170-1177</ispartof><rights>2012 European Society for Medical Oncology</rights><rights>2015 INIST-CNRS</rights><rights>The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-778f4113e42ea2d79a8908f1acb833b21e3110fee31f809949cd6e9df1fd154b3</citedby><cites>FETCH-LOGICAL-c465t-778f4113e42ea2d79a8908f1acb833b21e3110fee31f809949cd6e9df1fd154b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25846504$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21896543$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Classe, J.M.</creatorcontrib><creatorcontrib>Baffert, S.</creatorcontrib><creatorcontrib>Sigal-Zafrani, B.</creatorcontrib><creatorcontrib>Fall, M.</creatorcontrib><creatorcontrib>Rousseau, C.</creatorcontrib><creatorcontrib>Alran, S.</creatorcontrib><creatorcontrib>Rouanet, P.</creatorcontrib><creatorcontrib>Belichard, C.</creatorcontrib><creatorcontrib>Mignotte, H.</creatorcontrib><creatorcontrib>Ferron, G.</creatorcontrib><creatorcontrib>Marchal, F.</creatorcontrib><creatorcontrib>Giard, S.</creatorcontrib><creatorcontrib>Tunon de Lara, C.</creatorcontrib><creatorcontrib>Le Bouedec, G.</creatorcontrib><creatorcontrib>Cuisenier, J.</creatorcontrib><creatorcontrib>Werner, R.</creatorcontrib><creatorcontrib>Raoust, I.</creatorcontrib><creatorcontrib>Rodier, J.-F.</creatorcontrib><creatorcontrib>Laki, F.</creatorcontrib><creatorcontrib>Colombo, P.-E.</creatorcontrib><creatorcontrib>Lasry, S.</creatorcontrib><creatorcontrib>Faure, C.</creatorcontrib><creatorcontrib>Charitansky, H.</creatorcontrib><creatorcontrib>Olivier, J.-B.</creatorcontrib><creatorcontrib>Chauvet, M.-P.</creatorcontrib><creatorcontrib>Bussières, E.</creatorcontrib><creatorcontrib>Gimbergues, P.</creatorcontrib><creatorcontrib>Flipo, B.</creatorcontrib><creatorcontrib>Houvenaeghel, G.</creatorcontrib><creatorcontrib>Dravet, F.</creatorcontrib><creatorcontrib>Livartowski, A.</creatorcontrib><title>Cost comparison of axillary sentinel lymph node detection and axillary lymphadenectomy in early breast cancer. A national study based on a prospective multi-institutional series of 985 patients ‘on behalf of the Group of Surgeons from the French Unicancer Federation’</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>Our objective was to assess the global cost of the sentinel lymph node detection [axillary sentinel lymph node detection (ASLND)] compared with standard axillary lymphadenectomy [axillary lymph node dissection (ALND)] for early breast cancer patients.
We conducted a prospective, multi-institutional, observational, cost comparative analysis. Cost calculations were realized with the micro-costing method from the diagnosis until 1 month after the last surgery.
Eight hundred and thirty nine patients were included in the ASLND group and 146 in the ALND group. The cost generated for a patient with an ASLND, with one preoperative scintigraphy, a combined method for sentinel node detection, an intraoperative pathological analysis without lymphadenectomy, was lower than the cost generated for a patient with lymphadenectomy [€2947 (σ = 580) versus €3331 (σ = 902); P = 0.0001].
ASLND, involving expensive techniques, was finally less expensive than ALND. The length of hospital stay was the cost driver of these procedures. The current observational study points the heterogeneous practices for this validated and largely diffused technique. Several technical choices have an impact on the cost of ASLND, as intraoperative analysis allowing to reduce rehospitalization rate for secondary lymphadenectomy or preoperative scintigraphy, suggesting possible savings on hospital resources.</description><subject>Aged</subject><subject>Algorithms</subject><subject>Antineoplastic agents</subject><subject>Axilla - pathology</subject><subject>axillary lymphadenectomy</subject><subject>Biological and medical sciences</subject><subject>breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - economics</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Carcinoma - diagnosis</subject><subject>Carcinoma - economics</subject><subject>Carcinoma - pathology</subject><subject>Carcinoma - surgery</subject><subject>cost</subject><subject>Costs and Cost Analysis</subject><subject>Disease Progression</subject><subject>Female</subject><subject>France</subject><subject>General Surgery - organization & administration</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Length of Stay - economics</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Lymph Node Excision - economics</subject><subject>Lymph Node Excision - methods</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Lymphatic Metastasis - diagnosis</subject><subject>Mammary gland diseases</subject><subject>Medical Oncology - organization & administration</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging - economics</subject><subject>Original</subject><subject>Pharmacology. Drug treatments</subject><subject>Prospective Studies</subject><subject>sentinel lymph node</subject><subject>Sentinel Lymph Node Biopsy - economics</subject><subject>Societies, Medical</subject><subject>Tumors</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1ksFu1DAQhgMC0aUgTlyRL0hc0tpxsmtfKlUVW5AqcYCeLcced40SO9jOir31MeD1-iQ4m20LB06WNd_8_v3PFMVbgk8I5vRUOuedOu11oE3ztFiQZslLhmvyrFhgXtFy1dD6qHgZ43eM8ZJX_EVxVBHGl01NF0_eXPiYkPL9IION3iFvkPxpu06GHYrgknXQoW7XDxvkvAakIYFKNpPS6Ud0T0gNLhd9v0PWIZCh26E2gJxekE5BOEHnyMmpW3YoplHnuoyg0SSHhuDjMIlvAfVjl2xpXUw2jfcNECzEySFnDRqyTvYX0d3tr9zewkZ2ZiqmDaDL4Mdhunwdww14F5EJvt-X1gGc2qBrZ2dPaA0awt7U3e3vV8VzI7sIrw_ncXG9_vjt4lN59eXy88X5VanqZZPK1YqZmhAKdQWy0isuGcfMEKlaRmlbEaCEYAP5MAxzXnOll8C1IUaTpm7pcXE26w5j24NW-SdBdmIIts9xCi-t-Lfi7Ebc-K2glDZVXWeBDweB4H-MEJPobVSQp-HAj1EQjDnDhFKW0XJGVQ44BjAPzxAspiUS8xKJeYky_-5vbw_0_dZk4P0BkFHl1EMO0sZHrmE5JDx5XM0c5CS3FoKIKs9MgbYhz1lob_9j4Q_XQ--W</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Classe, J.M.</creator><creator>Baffert, S.</creator><creator>Sigal-Zafrani, B.</creator><creator>Fall, M.</creator><creator>Rousseau, C.</creator><creator>Alran, S.</creator><creator>Rouanet, P.</creator><creator>Belichard, C.</creator><creator>Mignotte, H.</creator><creator>Ferron, G.</creator><creator>Marchal, F.</creator><creator>Giard, S.</creator><creator>Tunon de Lara, C.</creator><creator>Le Bouedec, G.</creator><creator>Cuisenier, J.</creator><creator>Werner, R.</creator><creator>Raoust, I.</creator><creator>Rodier, J.-F.</creator><creator>Laki, F.</creator><creator>Colombo, P.-E.</creator><creator>Lasry, S.</creator><creator>Faure, C.</creator><creator>Charitansky, H.</creator><creator>Olivier, J.-B.</creator><creator>Chauvet, M.-P.</creator><creator>Bussières, E.</creator><creator>Gimbergues, P.</creator><creator>Flipo, B.</creator><creator>Houvenaeghel, G.</creator><creator>Dravet, F.</creator><creator>Livartowski, A.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120501</creationdate><title>Cost comparison of axillary sentinel lymph node detection and axillary lymphadenectomy in early breast cancer. A national study based on a prospective multi-institutional series of 985 patients ‘on behalf of the Group of Surgeons from the French Unicancer Federation’</title><author>Classe, J.M. ; Baffert, S. ; Sigal-Zafrani, B. ; Fall, M. ; Rousseau, C. ; Alran, S. ; Rouanet, P. ; Belichard, C. ; Mignotte, H. ; Ferron, G. ; Marchal, F. ; Giard, S. ; Tunon de Lara, C. ; Le Bouedec, G. ; Cuisenier, J. ; Werner, R. ; Raoust, I. ; Rodier, J.-F. ; Laki, F. ; Colombo, P.-E. ; Lasry, S. ; Faure, C. ; Charitansky, H. ; Olivier, J.-B. ; Chauvet, M.-P. ; Bussières, E. ; Gimbergues, P. ; Flipo, B. ; Houvenaeghel, G. ; Dravet, F. ; Livartowski, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-778f4113e42ea2d79a8908f1acb833b21e3110fee31f809949cd6e9df1fd154b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Algorithms</topic><topic>Antineoplastic agents</topic><topic>Axilla - pathology</topic><topic>axillary lymphadenectomy</topic><topic>Biological and medical sciences</topic><topic>breast cancer</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - economics</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Carcinoma - diagnosis</topic><topic>Carcinoma - economics</topic><topic>Carcinoma - pathology</topic><topic>Carcinoma - surgery</topic><topic>cost</topic><topic>Costs and Cost Analysis</topic><topic>Disease Progression</topic><topic>Female</topic><topic>France</topic><topic>General Surgery - organization & administration</topic><topic>Gynecology. 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We conducted a prospective, multi-institutional, observational, cost comparative analysis. Cost calculations were realized with the micro-costing method from the diagnosis until 1 month after the last surgery.
Eight hundred and thirty nine patients were included in the ASLND group and 146 in the ALND group. The cost generated for a patient with an ASLND, with one preoperative scintigraphy, a combined method for sentinel node detection, an intraoperative pathological analysis without lymphadenectomy, was lower than the cost generated for a patient with lymphadenectomy [€2947 (σ = 580) versus €3331 (σ = 902); P = 0.0001].
ASLND, involving expensive techniques, was finally less expensive than ALND. The length of hospital stay was the cost driver of these procedures. The current observational study points the heterogeneous practices for this validated and largely diffused technique. Several technical choices have an impact on the cost of ASLND, as intraoperative analysis allowing to reduce rehospitalization rate for secondary lymphadenectomy or preoperative scintigraphy, suggesting possible savings on hospital resources.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>21896543</pmid><doi>10.1093/annonc/mdr355</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0923-7534 |
| ispartof | Annals of oncology, 2012-05, Vol.23 (5), p.1170-1177 |
| issn | 0923-7534 1569-8041 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3335244 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Aged Algorithms Antineoplastic agents Axilla - pathology axillary lymphadenectomy Biological and medical sciences breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - economics Breast Neoplasms - pathology Breast Neoplasms - surgery Carcinoma - diagnosis Carcinoma - economics Carcinoma - pathology Carcinoma - surgery cost Costs and Cost Analysis Disease Progression Female France General Surgery - organization & administration Gynecology. Andrology. Obstetrics Humans Length of Stay - economics Length of Stay - statistics & numerical data Lymph Node Excision - economics Lymph Node Excision - methods Lymph Nodes - pathology Lymph Nodes - surgery Lymphatic Metastasis - diagnosis Mammary gland diseases Medical Oncology - organization & administration Medical sciences Middle Aged Neoplasm Staging - economics Original Pharmacology. Drug treatments Prospective Studies sentinel lymph node Sentinel Lymph Node Biopsy - economics Societies, Medical Tumors |
| title | Cost comparison of axillary sentinel lymph node detection and axillary lymphadenectomy in early breast cancer. A national study based on a prospective multi-institutional series of 985 patients ‘on behalf of the Group of Surgeons from the French Unicancer Federation’ |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T20%3A39%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cost%20comparison%20of%20axillary%20sentinel%20lymph%20node%20detection%20and%20axillary%20lymphadenectomy%20in%20early%20breast%20cancer.%20A%20national%20study%20based%20on%20a%20prospective%20multi-institutional%20series%20of%20985%20patients%20%E2%80%98on%20behalf%20of%20the%20Group%20of%20Surgeons%20from%20the%20French%20Unicancer%20Federation%E2%80%99&rft.jtitle=Annals%20of%20oncology&rft.au=Classe,%20J.M.&rft.date=2012-05-01&rft.volume=23&rft.issue=5&rft.spage=1170&rft.epage=1177&rft.pages=1170-1177&rft.issn=0923-7534&rft.eissn=1569-8041&rft_id=info:doi/10.1093/annonc/mdr355&rft_dat=%3Cproquest_pubme%3E1009801338%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1009801338&rft_id=info:pmid/21896543&rft_els_id=S0923753419346691&rfr_iscdi=true |