Presentation (CTI)

OBJECTIVES: Breast cancer treatment consumes substantial healthcare resources, yet the economic value delivered varies considerably depending on disease stage at diagnosis. Understanding this variation is essential for guiding policy decisions on early detection, resource allocation, and equitable access to care. The present study evaluated differences in treatment effectiveness and cost-effectiveness across breast cancer stages (I-IV) in a real-world patient cohort, and to quantify the value lost when diagnosis occurs at later stages.
METHODS: Patients treated at a private Brazilian health operator, with breast cancer diagnoses who completed treatment at least 3 months prior the data collection were identified included. Patient centred outcomes for composite treatment effectiveness calculation were collected, and total costs were recovered from administrative claim.
RESULTS: A total of 433 patients were identified with breast cancer, with outcome successfully collected from 203 - a response rate of 46.4%. Stage I patients achieved the highest mean effectiveness (70.4), at the lowest median cost, providing the most favourable cost-effectiveness ratio. Stage II patients showed moderately lower effectiveness (mean 70.6) with slightly higher median costs. While effectiveness did not statistically differ across stages (means 66.9-70.6), late stages patients (III and IV) demonstrated both the lowest effectiveness scores (means 66.9 and 68.2, respectively) and the most extreme cost variability, producing cost-per-effectiveness ratios several-fold higher than stage I. Across the full cohort, treatment costs were right-skewed and spanned more than four orders of magnitude, underscoring high heterogeneity within each stage.
CONCLUSIONS: Early-stage breast cancer diagnosis delivers substantially greater value per healthcare BRL spent. Late-stage disease is not only harder to treat effectively but imposes dramatically higher costs, compounding the burden on both patients and health systems. These findings provide quantitative support for investment in early detection programmes — including routine screening and timely diagnostic pathways — as a high-value strategy in breast cancer care.