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乳腺导管原位癌患者注射超顺磁性氧化铁(SPIO)的成本控制分析。

Cost containment analysis of superparamagnetic iron oxide (SPIO) injection in patients with ductal carcinoma in situ.

机构信息

Division of Surgical Oncology & Endocrine Surgery, Vanderbilt University Medical Center, Preston Research Building, 597, 2220 Pierce Avenue, Nashville, TN, 37232, USA.

出版信息

Breast Cancer Res Treat. 2024 Dec;208(3):565-568. doi: 10.1007/s10549-024-07451-2. Epub 2024 Aug 1.

Abstract

PURPOSE

Recent studies have established the safety and efficacy of Superparamagnetic Iron Oxide (SPIO, Magtrace®) for delayed sentinel lymph node biopsy (SLNB) in patients with ductal carcinoma in situ (DCIS) who are undergoing mastectomy. The aim of our study was to measure cost containment with use of Magtrace® in comparison to upfront SLNB with traditional technetium-99 lymphatic tracer.

METHODS

A total of 41 patients at our institution underwent mastectomy with Magtrace® injection for DCIS and were included in our single-institution, retrospective analysis. For comparison, total charges data were obtained for an upfront SLNB at the time of mastectomy. Cost comparison analysis was then performed against charges for intraoperative Magtrace® injection with additional charges incorporated for those patients who required return to the operating room for delayed SLNB. Total cost containment for the cohort with use of Magtrace® was then measured.

RESULTS

Of the 41 patients who underwent Magtrace® injection, two patients required return to the operating room for a delayed SLNB for invasive disease. Including these charges for a second encounter into our cost analysis, the use of Magtrace® still yielded an overall cost containment of $205,793.55 in our cohort when comparing to patients who underwent upfront SLNB. For patients who underwent Magtrace® injection and did not require return to the operating room, charges were reduced by $6,768.52 per patient.

CONCLUSION

The use of Magtrace® for delayed SLNB in patients with DCIS undergoing mastectomy yielded a significant overall cost containment, further supporting its use in this patient population.

摘要

目的

最近的研究已经证实了超顺磁性氧化铁(SPIO,Magtrace®)用于接受乳房切除术的导管原位癌(DCIS)患者延迟前哨淋巴结活检(SLNB)的安全性和有效性。我们的研究目的是测量使用 Magtrace®与传统锝-99 淋巴示踪剂进行 upfront SLNB 相比的成本控制。

方法

我们机构的 41 例患者在接受乳房切除术时接受了 Magtrace®注射用于 DCIS,并纳入我们的单机构回顾性分析。为了比较,在乳房切除术时获得了 upfront SLNB 的总费用数据。然后对术中 Magtrace®注射的费用进行了成本比较分析,并对需要返回手术室进行延迟 SLNB 的患者的额外费用进行了分析。然后测量了使用 Magtrace®的队列的总成本控制。

结果

在接受 Magtrace®注射的 41 例患者中,有 2 例患者因浸润性疾病需要返回手术室进行延迟 SLNB。将这些第二次手术的费用纳入我们的成本分析中,与接受 upfront SLNB 的患者相比,使用 Magtrace®在我们的队列中仍然产生了 205793.55 美元的总体成本控制。对于接受 Magtrace®注射且无需返回手术室的患者,每位患者的费用减少了 6768.52 美元。

结论

在接受乳房切除术的 DCIS 患者中使用 Magtrace®进行延迟 SLNB 可显著降低总体成本,进一步支持在该患者群体中使用。

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Twenty-Five Year Trends in the Incidence of Ductal Carcinoma in Situ in US Women.美国女性导管原位癌发病率 25 年趋势
J Am Coll Surg. 2019 Jun;228(6):932-939. doi: 10.1016/j.jamcollsurg.2019.01.018. Epub 2019 Feb 15.

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