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A Comparison of the Costs of Sentinel Lymph Node Biopsy and of Axillary lymph Node Dissection in the Management of Early-stage Breast Cancer in Ontario

Objective: To complete a cost-minimization analysis (CMA) of the cost of sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) in the management of early-stage breast cancer (ESBC) in a hypothetical Ontario hospital setting.

Methods: Decision-analysis modeling, with a decision-tree and Markov states, was used to estimate hospital costs for the two treatment options. The model was populated with data from the literature and costs from the Ontario Case Costing Initiative, a publicly accessible, government-sponsored, costing database. Model variability and parameter uncertainty were quantified by probabilistic sensitivity analysis (PSA).

Results: The SLNB treatment algorithm was cost-minimizing compared to the ALND-only treatment option. The costs of treating postoperative complications did not contribute to the incremental average cost.

Conclusion: A treatment algorithm that involves SLNB as the initial axillary-staging procedure in the setting of ESBC offers a cost-savings over the ALND-only option. This result is generalizable to all Ontario hospitals.

Identiferoai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/18993
Date17 February 2010
CreatorsWells, Bryan John
ContributorsCoyte, Peter C., Quan, May Lynn
Source SetsUniversity of Toronto
Languageen_ca
Detected LanguageEnglish
TypeThesis

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