Department of Surgical Oncology, Institut Curie, Saint-Cloud, France.
Inserm U900 -Bioinformatics, Biostatistics, Epidemiology and Computational Systems, Cancer Biology, Institut Curie, Saint-Cloud, France.
PLoS One. 2018 Aug 23;13(8):e0202385. doi: 10.1371/journal.pone.0202385. eCollection 2018.
Breast cancer (BC) screening has been developed to detect earlier stage tumors associated with better prognosis. The aim of study was to evaluate the impact of BC screening on therapeutic management of patients with first operable BC, and on costs, patients' needs, and working life. OPTISOINS01 was a multicenter, prospective observational study which aimed to identify the main care pathway of early BC. Among patients aged from 50 to 74 years-old, 2 groups were defined: the "Clinical signs" group and the "Screening" group (national organized screening and individual screening). We compared between these 2 groups: locoregional and systemic treatments, direct medical and non-medical costs from a National Health Insurance perspective, patients' needs assessed by the validated SCNS-BR8 "breast cancer" module of the SCNS-SF34 supportive care needs survey and the duration of sick leave. The "Clinical signs" group included 89 patients, while the"Screening" group included 290 patients. More axillary lymph node dissections and radical breast surgery were performed in the "Clinical signs". The rate of adjuvant chemotherapy was dramatically higher in the "Clinical signs" group. The median direct medical costs of the "Screening" group were €11,860 (€3,643-€41,030) per year and per patient, much lower than in the "Clinical signs" group (€14,940; €5,317-€41,070). Finally, needs specifically assessed by the SCNS-BR8 questionnaire were significantly higher for the postoperative and post-adjuvant periods in the "Clinical signs" group. This study highlighted the benefit of BC screening in terms of reduced therapies and positive impact on work and social life.
乳腺癌（BC）筛查旨在检测与更好预后相关的早期肿瘤。本研究旨在评估 BC 筛查对首次可手术 BC 患者治疗管理的影响，以及对成本、患者需求和工作生活的影响。 OPTISOINS01 是一项多中心、前瞻性观察研究，旨在确定早期 BC 的主要护理途径。在 50 至 74 岁的患者中，定义了 2 个组：“临床体征”组和“筛查”组（国家组织筛查和个体筛查）。我们比较了这 2 个组：局部和全身治疗、从国家健康保险角度看的直接医疗和非医疗费用、通过验证的 SCNS-BR8“乳腺癌”模块评估的患者需求，以及病假时间。“临床体征”组包括 89 例患者，而“筛查”组包括 290 例患者。“临床体征”组中更多地进行腋窝淋巴结清扫术和根治性乳房切除术。“临床体征”组中辅助化疗的比例显著更高。“筛查”组的直接医疗费用中位数为每年每位患者 11860 欧元（3643-41030 欧元），远低于“临床体征”组（14940 欧元；5317-41070 欧元）。最后，通过 SCNS-BR8 问卷专门评估的术后和辅助治疗期间的需求在“临床体征”组中显著更高。这项研究强调了 BC 筛查在减少治疗和对工作和社会生活的积极影响方面的益处。
