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A 4-Year Longitudinal Study

Antonio P. Legorreta, MD, MPH; Ronald J. Brooks, MD; Arthur N. Leibowitz, MD; Lawrence J. Solin, MD

Arch Intern Med. 1996;156(19):2197-2201.

Abstract
Objective
To determine the longitudinal cost of the treatment of patients with breast cancer.

Methods
An analysis was performed of 200 women with 205 newly diagnosed breast cancers during 1989 in a health maintenance organization population (US Healthcare, Blue Bell, Pa). Medical records and claims data were analyzed for the total costs of medical care during the 4-year period after diagnosis. The costs over time were analyzed for clinical stage and use of mammography screening.

Results
The total costs of medical care during the 4-year period after diagnosis were strongly related to clinical stage at diagnosis, with higher total costs for patients with stages III to IV at diagnosis compared with patients with stages 0 to II at diagnosis. The cost for all stages of disease declined after years 1 to 2, with the exception of stage II, which increased slightly in years 3 to 4. The use of screening mammography was associated with a significant decrease in the cost of medical care during the 4-year study period.

Conclusions
The goal of mammography screening programs should be to achieve downstaging to stages 0 to I to achieve reduction in breast cancer mortality and to reduce the overall consumption of health care resources for the treatment of breast cancer. These cost data should be considered within the framework of future cost-effective analysis for screening mammography programs.

Arch Intern Med. 1996;156:2197-2201

Author Affiliations
From Health Net, Woodland Hills, Calif, and the Department of Community Medicine, Mount Sinai School of Medicine, New York, NY (Dr Legorreta); US Healthcare, Blue Bell, Pa (Drs Brooks and Leibowitz); and the Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia (Dr Solin).

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