ArticleJournal of surgical oncology2026
Patient Out-of-Pocket Costs and Healthcare Utilization Related to Mastectomy vs Breast Conservation: A Claims-Based Study.
Article in Journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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9 authors.
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Abstract
BACKGROUND AND
objectivesOut-of-pocket (OOP) costs and healthcare utilization remain unknown for women facing breast conservation and mastectomy.
methodsWomen aged 18-64 who underwent upfront breast cancer surgery were identified from the IBM MarketScan Commercial Claims Database (2014-2017). Surgical groups included lumpectomy+radiation; unilateral mastectomy + /-reconstruction, and bilateral mastectomy + /-reconstruction. Cumulative OOP payments were assessed at 12-month intervals over 4 years postoperatively and adjusted to 2017 USD$. Multivariable regression identified factors associated with increased OOP costs.
resultsOverall, 23,159 underwent lumpectomy with radiation (60%), unilateral mastectomy with (15%) and without (6%) reconstruction, and bilateral mastectomy with (17%) and without (2.6%) reconstruction. Women undergoing bilateral mastectomy+reconstruction were younger than other surgical groups (median age 49 vs. 50-55). In the first year after diagnosis, 1.24 million outpatient visits occurred, 27% of enrollees had inpatient admissions, 23% visited an E.R., and median OOP costs were $5669 (range $0 to $132 125). Cumulative costs were significantly higher in women < 45 yo and for those with greater comorbidities. Median OOP costs declined over time (0-12 months: $3661 vs 48 months: $486). OOP costs were 12% higher (8.9%-15.1%) with mastectomy+reconstruction than lumpectomy+radiation ($6529 vs $5333).
conclusionsOut-of-pocket costs and healthcare utilization differ between equally effective surgical treatment options; mastectomy + reconstruction is costlier for patients than breast conservation.
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