Finances Affect Women’s Choice of Breast Cancer Treatment: Study

In In The News by Barbara Jacoby

Source: Duke University


Cost often influences breast cancer patients’ decisions about surgery, even if they have good incomes and insurance, a new study finds.

“Eligible women with early-stage breast cancer often have choices for surgical treatments that are equally effective and result in excellent cancer outcomes,” said lead study author Dr. Rachel Greenup. She is a surgeon at Duke Cancer Institute in Durham, N.C.

“Surgeons often discuss the emotional and physical side effects of treatment, yet we rarely discuss the costs,” Greenup noted in an institute news release.

For the study, the researchers surveyed more than 600 women with stage 0 to stage 3 breast cancer. Of those, 90% were white; 70% had private health insurance; 25% had Medicare; 78% were college educated; and 56% had household incomes above $74,000 a year.

Even though the women were more affluent than the U.S. average, 43% said cost was a consideration when deciding on treatment, and nearly one-third said it played into the type of surgery they chose.

Among women with annual household incomes below $45,000, treatment cost was more important than keeping their breast or its appearance, the study findings showed.

Also, 35% said their treatment caused a financial burden, and 78% never discussed costs with their cancer care team. Even among top earners, 65% said they were financially unprepared for the cost of their cancer treatment.

Of the types of breast cancer surgeries — lumpectomy with radiation; mastectomy; and double mastectomy with or without breast reconstruction — double mastectomy was associated with higher patient debt and financial hardship.

The findings were published online July 29 in the Journal of Oncology Practice.

“Women are weighing many factors when deciding what type of surgery is best for them, including their personal desire for breast preservation, options for reconstruction, recovery time, sexuality, appearance, demands for future surveillance, and their own peace of mind,” Greenup said.

“While other side effects of surgical choice are routinely discussed with their physicians, the potential for financial harm is not explicitly addressed, including both the out-of-pocket payments and lost productivity for patients and their families,” she added. “Our study suggests this should change.”

More information

The American Cancer Society has more on breast cancer surgery.