The Cost of Breast Cancer Treatment: What are the Contributing Factors?

In a recent survey of patients diagnosed with early-stage breast cancer, 38% said they were worried about finances due to their treatment. 14% said that their breast cancer cost them at least 10% of their household income. 17% said that they had spent even more than that 10% on out-of-pocket medical expenses.

When doctors, surgeons, and radiation oncologists were asked about how their offices handle financial discussions with their patients, 50% of medical oncologists reported that someone in their practice “often or always discusses financial burden” with their patients. 43% of radiation oncologists said they did as well. Only 16% of surgeons reported the same.

Furthermore, no one seems to know, going in, just how far a diagnosis of breast cancer is going to set them back financially. It is difficult to find answers about the cost of treatment, whether for surgery, radiation, or other medications. We are taking this chance to clear the air between doctors and patients; we can give the answers that so many have been looking for and help to start the conversation so you can be prepared should this diagnosis ever come your way.

Total Costs

In 2010, breast cancer was the highest-costing cancer in the United States. Nationwide, it cost a total of $16.5 billion. By 2020, this is expected to increase to $20.5 billion. The American Cancer Society estimates that over $180 billion is spent on health care expenses and lost productivity every year due to cancer.

Of course, each person’s case is unique. Their access to insurance must be taken into consideration. Different stages of cancer are harder to treat than others, which can affect overall treatment costs. Not to mention that disease takes root differently in each person, so it must be treated differently. And with no one-size-fits-all treatment, there is no one-size-fits-all price tag. All of these factors must be considered.

Stages

The stage at which a patient’s breast cancer is discovered significantly affects how difficult it is to treat. A study was done recently and published in The American Health and Drug Benefits1 on the cost and frequency of some treatments based on the cancer stage and how long it had been since the diagnosis.

It was not much of a surprise to find that those patients with more advanced stages of breast cancer spent more on treatments. For those with stage 0 cancer, the average cost of treatment at twelve months after diagnosis was $60, 637. After twenty-four months, the price had jumped to $71, 909 per patient overall.

For those whose cancer had advanced to stages I-II, their medical costs were approximately $82,121 in the first twelve months of treatment. In the second twelve months, each patient still in the study brought the total average to $97, 066.

With breast cancer in stage III, the average cost in the first twelve months continued to rise to $129,387. After a full twenty-four months, the study reported that patients spent an average of $159,442.

At stage IV, the most difficult to treat, the average treatment costs were $134,682 at twelve months and $182,655 at twenty-four.

According to the study, patients were paying an average of $85,772 within the first twelve months of being diagnosed with breast cancer, despite their cancer stage. And within the first two years of their diagnosis, the study reported their treatment costs averaging $103,735.

Treatments

Another major factor that will contribute to the overall cost of breast cancer treatment is the kind of treatment a patient is receiving. Which treatment you receive depends on the location, cancer stage, and extent to which the disease has spread. Sometimes the procedures are combined to get the best results and return you to health quicker and more effectively. The same study mentioned above also explored the average amount spent on categories of treatments, and how common these kinds of treatments were within the given periods.

Surgery

Surgery is a standard treatment for a breast cancer diagnosis. If applicable, it is a way to remove cancer physically from where it has taken root. Altogether, surgical treatment accounts for an average of 20% of the cost of breast cancer care treatments within the first year after diagnosis, and 4% in the second year.

  • Inpatient breast cancer surgery accounts for 6% of the cost treatment in the first year, and 2% in the second year. In the first year of treatment, the cost of breast cancer surgery is, on average, $4,762, while in the second year after diagnosis, the cost is approximately $347.
  • Outpatient breast cancer surgery accounts for approximately 14% of the price of breast cancer treatment in the first twelve months, and 2% in the second. The cost of outpatient surgery in the first and second years were found to be, on average, $11,691 and $389 respectively.

Chemotherapy

Chemotherapy is another well-known treatment of cancer. It accounts for approximately 19% of breast cancer treatment in both the first and second year after diagnosis.

  • For general chemotherapy, the average cost (including all costs on the day of the treatment) in the first year is $15,113. As this accounts for 18% of the payment for treatment for breast cancer, this is particularly significant. In the second year post-diagnosis, the average cost for this treatment is $3,625. This makes up 16% of all breast cancer treatment costs.
  • Oral chemotherapy is far less conventional. It only accounts for approximately 1% of the costs of first-year treatment, and 3% in the second year. Patients are usually paying $432 in their first year and $636 in their second year for this treatment.

Radiation

Radiation is used to kill the tumors by damaging cancer cells’ DNA. It is often used in combination with surgery. It makes up 18% of diagnosis treatment costs in the first year and 3% in the second year. In the first year, it costs an average of $15,455, while in the second year, patients pay $638.

Medication

Hand in hand with these major treatments come medications. Medications make up for 3% of the first year’s medical payments, and 7% of the second year. That equates to approximately $2,258 and $1,510 respectively.

Other Treatments

There are, of course, other treatments. Smaller subcategories that don’t quite fit these above, including hormone therapy, additional inpatient or outpatient care, or professional or specialist care. They make up about 42% of potential treatment costs in the first year and 67% of costs in the second year. That equates to $35,762 in the first twelve months and $14,980 in the second.

Health Insurance

Another factor that contributes to the overall cost of breast cancer treatment is health insurance. Healthcare, the amount of coverage you have, and the type of coverage you have, are all essential to discuss with your doctor, oncologist, and surgical team to make sure you understand where you stand.

Researchers in North Carolina found that patients who received a cancer diagnosis and did not have insurance or Medicare paid $6,711 for medication, while those with insurance paid $3,616 and those with Medicare paid $3,090 simply because they do not have the means to negotiate for a lower price.

Often, clinical appointments are more costly, as well. Where an insured patient might pay approximately $65-246, a patient without insurance coverage would pay around $129-391.

Ask Questions/Dr. Gorman

Getting a diagnosis of breast cancer is near impossible to imagine, and even harder to plan for. But if you ever find yourself in that place, you have a little more knowledge about what to expect. One should always be prepared for the unexpected, and it never hurts to have a little money saved up for emergencies. But breast cancer treatment costs will require more than just a bit of your savings. However, with communication with your team and laying out your healthcare terms and concerns as you discuss your health plan, everyone can be on the same page and do what they can to work within your needs.

Dr. Valerie Gorman knows about the financial burden that comes with breast cancer. She is dedicated to offering her patients a personalized approach to breast surgery and the treatment of breast cancer. She and her team will help to create a treatment plan that best meets your needs, and most fits your lifestyle. Because of the experience and breadth of our specialists, a multitude of treatment options exists which can be tailored to your situation.

There is no need to panic when you hear the word cancer. We have walked alongside many people who have been diagnosed and understand your fears and concerns. It is our privilege to walk with you and help you through this difficult process.

 

 

 

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822976/#idm139828318640480title

 

 


What is Hidden Scar Breast Cancer Surgery?

When someone is first diagnosed with breast cancer, their first concern is not often about their appearance. They might first consider prognosis. Can the surgeons get the cancer out? What are the treatment options? But if surgery is necessary, the cosmetic applications are a consideration. Your breast cancer team wants you to have the best results possible, including minimal scarring.

Breast Cancer Surgery

There is more than one way to remove tumors and cancerous cells surgically. Surgery options for the more extreme cases are the simple or total mastectomy, the radical mastectomy, and the double mastectomy. For the less severe cases are the lumpectomy or partial mastectomy, the nipple-sparing mastectomy, and the skin-sparing mastectomy. While these are still serious surgeries, these procedures can allow the patient to keep more of their natural breast shape with less dramatic scarring. While the type of procedure can certainly depend on how big the tumor or cancerous area is, treatment ultimately comes down to you, the patient, and your needs.

Breast Cancer Scars

The different variations of surgical procedures lead to different appearances, sizes, and locations for scars. With a total mastectomy, where all of the breast tissue, skin, and the nipple are removed, there will be a noticeable change in appearance. That area of the chest will be flat, and there will be a visibly large scar where the breast was.

With a skin-sparing mastectomy, the skin remains, but the nipple and breast tissue are removed. There is some room for reconstruction here under the skin, but there will still be a medium- to large-sized and prominent scar across the front of the breast.

A nipple-sparing mastectomy, however, leaves the skin and nipple and takes only the breast tissue and tumor. The scar traditionally branches off from the areola towards the armpit. It is still on the medium to large side of the scale and quite noticeable.

A lumpectomy only removes a portion of the breast tissue–that closes to the tumor–to ensure that none of the tumor is missed. This, too, can leave a large scar, which is quite visible depending on the location of the tumor and the surgeon’s approach.

All of these treatment options and their variations can be very effective with a skilled surgeon and oncology centers you are comfortable with. But they can leave a noticeable scar that many patients find a disheartening reminder:

  • 72% of women did not realize how uncomfortable their breast cancer surgery scars would make them feel when undressed
  • 72% of women are not displeased with the location of their scar
  • 76% of women did not realize how uncomfortable their surgery scars would make them feel when someone else sees them undressed
  • 82% of women have not worn a particular item of clothing because it reveals their breast cancer surgery scars
  • 87% of women are self-conscious due to their scars

Hidden ScarTM Breast Cancer Surgery

In 2015, Invuity launched a new surgical approach to assist with just this issue. The Hidden ScarTM Breast Cancer surgery program was created to help surgeons and patients by offering less invasive methods of performing the surgery.

The Hidden Scar procedure allows for a smaller incision while still providing light in the surgical site, permitting the surgeons to treat the cancer and remove the tumor while still preserving as much of the breast’s natural shape as possible. More than that, this hidden scar process offers better cosmetic results by, as the name suggests, hiding the scars in the body’s natural folds.

Hidden Scar Mastectomy

For a nipple-sparing mastectomy, the Hidden Scar Breast Cancer Surgery scar will dramatically decrease. There can be no evidence of any cancer within the nipple for Hidden Scar Surgery, and this surgery is best suited to patients who have non-invasive cancer.

The Hidden Scar mastectomy is performed by making an incision in the inframammary fold, or the natural fold under your breast. It will naturally be hidden by the fall your breast and its small size.

Hidden Scar Lumpectomy

A Hidden Scar Lumpectomy offers options for where the incision will go, depending on where the cancer is located in the breast.

  • The Axilla, or under the armpit. The scar is usually hidden in a natural fold.
  • Around the edges of the areola. Many patients prefer this option, as the scaring is minimal and hidden even when wearing a petite bikini top.
  • The Inframammary fold – like the mastectomy.

Dr. Gorman and Hidden Scar

Dr. Valerie Gorman and her team have experience with the Hidden Scar approach. They have performed Hidden Scar Breast Cancer Surgery and understand the differences and options that come from each approach to oncological surgery. Dr. Gorman knows that it is important to discuss all of your options when it comes to your health and will answer any questions you may have until you can come to a conclusion with which you are happy. Contact the Texas Breast Center in Waxahachie to make an appointment and have any questions answered.

 


The BioZorb Marker Could Help Post-Surgical Breast Cancer Results and Clinical Imaging

What is BioZorb?

The BioZorb marker is a medical device meant to be implanted in the surgical site. Thanks to its open structure, it can be stitched into place by breast surgeons to avoid movement and allow the surrounding tissue to grow around the device after the procedure. The marker has six titanium clips that are used for future clinical imaging.

What is BioZorb Made of?

The structure itself is made of a material that is bioabsorbable, or able to be absorbed by the body. Therefore, as the tissue grows and reforms, the BioZorb can be absorbed, leaving behind only the titanium clips as tissue markers for imaging if necessary. This process takes approximately a year.

How Does BioZorb Help?

Using a BioZorb implant in breast cancer treatment can be helpful surgically, cosmetically, and with radiation treatment. Surgically, the implant–or the titanium clips if the implant has already been absorbed–can provide a perfect reference point for any future imaging for where the previous breast surgery and radiation procedures took place.

It can also assist with the structure of healing, which lends itself to improved breast cosmesis. Often with tumor removal, the breast can appear concave where the tissue grew in to fill the void the tumor left. However, BioZorb offers structure for the surrounding tissue to grow around to prevent any potential divots. This can sometimes help with oncoplastic surgery or post-lumpectomy cosmetic surgery. As for radiation therapy, the implant can provide a target for the beam to minimize the radiation damaging any surrounding tissue unnecessarily.

What are some facts about BioZorb?

Your doctor is placing an implant into your breast during this surgery. The implant is firm, but not painful and can usually be felt in the breast for 12 to 18 months, even once the surgical scars have healed. It will eventually be absorbed by the body.

When should BioZorb be used?

It is not uncommon for a patient to react strongly when they hear a diagnosis of breast cancer. They may want to avoid any risk and go straight for the total mastectomy, removing the full breast and therefore the cancer.

However, with a breast cancer team working with you on your treatment, there is more room for a personalized approach. The cancer can be treated with surgery, radiation, or a combination of the two, and when it is caught at an early stage, a total mastectomy is not needed. A lumpectomy can remove a tumor while leaving most of the breast intact.

It is in these cases that BioZorb is useful. When a patient is able to receive breast-conserving surgery, the cancerous tissue is removed by the breast surgeon, and then the skin is closed. From there, radiation may be administered by a radiation oncologist to reduce the risk of recurrence without damaging the surrounding tissue. This can be difficult without something in the breast to mark where the surgery took place. Sometimes, the empty space of the surgical site where the tumor was will fill with a liquid, forming a seroma, and this can be an indication of where to radiate.

However, if BioZorb is placed in the breast during surgery, the metal marker clips work like a road sign pointing the way for the radiologist to follow. Even after the body absorbs the coils, the clips remain in case they are needed again for imaging purposes.

Dr. Gorman and BioZorb

Dr. Valerie Gorman uses BioZorb in applicable cases to help her patients recover with less pain, less cosmetic adjustment, and more accurate imaging. But she did not take this step lightly. Before jumping all in with BioZorb, she was involved with a study testing accelerated partial breast irradiation (APBI) using her preferred intensity modulated radiation therapy (IMRT). The IMRT was directed in each of the 57 cases by a BioZorb device to keep the radiation localized.

They found that, in the follow-up visits, the cosmetic results were excellent on all accounts. Only one patient experienced pain in the area, at it was easily treated. Patients were pleased with the results.

Dr. Gorman has worked with BioZorb before, and she and her team know the benefits it can bring. She will answer any questions you have. She always wants you to be comfortable and knowledgeable about your treatment, which is why she has done her own research into BioZorb. She wants you to receive the best treatment and best results long term.


Is Chemotherapy Necessary Before or After Breast Cancer Surgery, or At All?

Is Chemo necessary for breast cancerChemotherapy is an effective way to treat and prevent the spread of breast cancer, but new research suggests it is not always necessary.

A recent study found that breast cancer has been highly over treated with chemotherapy and doctors can now confidently provide an alternative treatment known as Endocrine Therapy.

However, each patient is different with a unique set of circumstances. Chemotherapy is necessary in advanced stages, as well as early stages when specific characteristics are present, such as spreading to the lymph nodes or other body parts.

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Sentinel Lymph Node Biopsy Procedure: Key Facts You Need To Know

Cancer is perhaps the scariest word in the dictionary, capable of striking fear into the heart of anyone who hears it inside of a second. Part of the problem is that the minute a doctor says that word, anything that he or she says subsequently becomes a total blur. It is like the patient is trying to listen to the doctor while being underwater. That’s the reason we have a resource section on our site. This article answers questions about the procedure for a biopsy of the sentinel lymph node.

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Lumpectomy Surgery Recovery – What To Expect

lumpectomy surgery recoveryHumans by their very nature do not like the unknown, which might explain why one of the most frequent questions we are asked at the Texas Breast Center is what to expect regarding your lumpectomy surgery recovery.

This is something that Dr. Gorman always explains in great detail, before the operation as it is essential that our patients have the proper care and support systems in place so that they can recover quickly.

The good news is that due to advances in technology, for most women having a lumpectomy procedure there is no need for an overnight stay. Nobody likes the thought of spending time in a hospital bed, so this normally brings a great deal of relief to our patients, being able to go home to your bed, and be surrounded by your family is an excellent way to start the recovery process.
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How Developments In Breast Cancer Research Have Improved Treatment In The Last Thirty Years

breast cancer treatmentWe want to feature a recent study by Rufus Mark, MD, Gail Lebovic, MD, Valerie Gorman, MD, Oscar Calvo, PhD. on recent developments in Breast Cancer Treatment.

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Streamlined Treatment for Breast Cancer Reduces Your Treatment Time

Partial breast radiation offered by Dr. Valerie Gorman, Breast Surgeon at Texas Breast Center, may reduce some treatment time by two-thirds.New radiation option cuts time by two-thirds

By Valerie Gorman, MD, FACS, Breast Surgeon at Texas Surgical Specialists

If you receive a diagnosis of breast cancer, it can be overwhelming. You’ll have to sort through a lot of information quickly and make decisions about what treatment is best for you.

For many of my patients with early stage breast cancer, lumpectomy – removing the tumor surgically – is the recommended treatment option. But you have to have radiation after a lumpectomy. That’s part of the package.

Continue reading “Streamlined Treatment for Breast Cancer Reduces Your Treatment Time” »