Published Jun 30, 2014

Bangkok, Thailand – The incidence of breast cancer in Thailand has increased over the last decade. Although advanced treatments have resulted in the improvement in survival rates and quality of life, surgery has caused morbidity in breast cancer patients. Even though armedema (or frozen shoulder) had been found in nearly 20% of patients after the operation, axillary lymph node dissection (ALND) has been an essential procedure in breast cancer treatment for many years. Sentinel lymph node biopsy (SNB) which had fewer complications is accepted worldwide as an alternative to axillary dissection. Since SNB is limited in Thailand due to a lack of personnel and facilities, researchers from Srinakharinwirot University and the Health Intervention and Technology Assessment Program (HITAP), who assessed the cost-utility analysis comparing axillary lymph node dissection with sentinel lymph node biopsy in early stage breast cancer patients in Thailand, performed an economic evaluation to compare the cost-effectiveness of ALND and SNB. In the study “A Cost-Utility Analysis Comparing Standard Axillary Lymph Node Dissection with Sentinel Lymph Node Biopsy in Early Stage Breast Cancer Patients in Thailand,” developed in Bangkok, Thailand, the researchers aimed to provide data for health care providers and policy makers on whether SNB should be put into clinical practice throughout the nation. The armedema rate and local recurrence of breast cancer after both procedures were included in a 5-year time horizon decision tree. The study showed that SNB gained more quality-adjusted life-years (QALYs) and cost less than ALND. The SNB was more cost-effective than ALND in both the provider and societal perspectives. Dolrudee Songtish, MD, MSc, the lead author of the study said, “Sentinel lymph node biopsy is an economically alternative treatment to ALND and should be implemented nationwide. This will require support from relevant stakeholders, including medical personnel and policy makers.”

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