Presentation (CTI)

OBJECTIVES: Costs associated with breast cancer care exhibit substantial variability both within and across subtypes, driven by disease aggressiveness, stage at diagnosis, treatment intensity, and patient specific factors such as age, comorbidities, and genetic mutations (e.g., BRCA1/2).This work aims to analysis of cost variability based on breast cancer molecular subtype .
METHODS: Nine samples from breast cancer patients, stratified by HER2 status and chemotherapyuse, were analyzed. For each group, descriptive measures (mean, median, standarddeviation, interquartile range (IQR) , ( MAD ) - mean absolute deviation, CV ) werecalculated. Box plots and a CV vs. IQR matrix were used to visualize the dispersion.Levene's test and the Mann-Whitney U test were applied to assess statistical differencesbetween the groups.
RESULTS: HER2-negative samples without chemotherapy and HER2-positive samples withoutchemotherapy showed the lowest CV and IQR values. Specifically, the HER2-negativegroup without chemotherapy demonstrated the best stability profile, with low relative andabsolute dispersion, being consistently positioned in the lowest risk quadrant in thedecision matrix. Levene's test demonstrated significant differences in variance betweenthe groups, while the Mann-Whitney test confirmed differences in cost distributions. Thedecision matrix allowed the subgroups to be classified according to their suitability forbundles.
CONCLUSIONS: The findings reinforce the need for segmentation by clinical andmolecular profile. In particular, the HER2- group shows promise for the adoption ofbundles, not only due to its clinical homogeneity, but also due to its lower average costand lower variability, key attributes for financial sustainability. The proposedmethodology allows the identification of groups with a more stable cost profile, enablingthe safe and efficient adoption of bundled payment models in breast oncology. The CV vsIQR matrix proves to be a decision support tool for managers and health insurancecompanies. The HER2- group, especially without chemotherapy, emerges as the logicalfirst choice for the implementation of care bundles.