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The Financial Side Effects of Breast Cancer Treatment: Transparency, Toxicity, and the Impact on Patient Choice

Rachel Greenup, MD, MPH, Duke Cancer Institute, Durham, North Carolina
Study abstract

The high costs of cancer treatment have become unsustainable for many patients. With the growing burden of out-of-pocket costs, approximately 25% of all cancer patients report using all or most of their savings to pay for treatment. At the time of their cancer diagnosis, average-risk women with early-stage breast cancer are faced with multiple equally effective surgical treatment options. These include lumpectomy with radiation (removal of the tumor with radiation to the remaining breast or “breast conservation”), mastectomy with or without reconstruction, and in many cases, the option of pursuing contralateral prophylactic mastectomy (CPM) with removal of the unaffected breast. Research supports that women prioritize different variables when making a treatment choice, including the personal desire for breast preservation, options for breast reconstruction, recovery time, need for long-term surveillance, and fear of recurrence. Though patients’ physical and emotional well-being are openly addressed when discussing these options with their cancer team, their financial well-being is rarely discussed. To date, no research has been published on how breast cancer patients are impacted by the costs of their treatment, or how knowledge of treatment costs may have impacted women’s treatment decisions. This survey-based project is aimed at better understanding how women diagnosed with breast cancer are impacted by the costs of their breast cancer care. Survey questions are based on previously published and validated questionnaires, addressing experiences and perceptions surrounding cancer treatment costs in breast cancer.

Study review

This study investigated how women make decisions about surgical treatment for breast cancer. The research team also wanted to learn how financial concerns influence treatment decisions and how treatment costs affect women after treatment has ended. The researchers wanted to enroll up to 5000 volunteers and used the Army of Women (AOW) as one of their recruitment sources. The Call to Action for this study was sent to AOW members on January 20, 2017. The researchers closed enrollment on June 15, 2017. The AOW provided them with 744 volunteers who were interested in enrolling in the study.