‘ONE SIZE FITS ALL’ GUIDELINE NOT COST-EFFECTIVE FOR ALL WOMEN WITH EARLY BREAST CANCER

Published Nov 18, 2014
Adelaide, South Australia - Due to early diagnosis and improved treatment, the number of breast cancer survivors is increasing. All of these women will need follow-up mammography to detect recurrent or new disease. International breast cancer clinical guidelines recommend annual follow-up mammograms for every woman after treatment for early breast cancer, regardless of their risk of recurrence. In the study, “A Patient-Level Calibration Framework for Evaluating Surveillance Strategies: A Case Study of Mammographic Follow-Up After Early Breast Cancer,” researchers from the University of Adelaide - Discipline of Public Health demonstrate the use of de-identified, routinely collected health service data and simulation modelling to predict the long-term costs and health outcomes of alternative mammography schedules for women, based on their age and the features of their primary breast cancer. The results showed that for younger postmenopausal women at moderate risk of recurrence, annual follow-up for five years, with two yearly visits thereafter appears to be cost-effective. For older women, a mammography schedule similar to screening intervals in the general population (2 yearly) is likely to be most cost-effective, if women continue to attend follow-up mammography. The researchers conclude that the current ‘one size fits all’ guideline of annual follow-up mammography may not be cost-effective for all women with early breast cancer. If the results are validated with larger, better quality datasets, this work could set the stage for personalised mammographic follow-up after breast cancer. Study author, Professor Jon Karnon states, “Early diagnosis and more effective treatment have significantly improved the prognosis of many cancer patients, but approaches to surveillance have not changed. These results indicate the potential to improve surveillance of cancer survivors from both a patient and health system perspective.”

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