An early economic evaluation of active surveillance for low-risk ductal carcinoma .

Perform early economic evaluation comparing active surveillance (AS) to surgery for women with low-risk ductal carcinoma , a precursor of invasive breast cancer. A 10-year incremental costs (€) and quality-adjusted life years (QALYs) were compared between a simulated cohort of women undergoing breast conserving surgery ± radiotherapy, and a cohort with a low-risk subgroup undergoing AS using a semi-Markov model. Scenario and headroom analyses evaluated a better-performing biomarker to select low-risk women for AS. AS resulted in lower costs and survival, but higher QALYs (±0.40). Scenario analyses maintained survival outcomes and maximized QALYs. AS for low-risk ductal carcinoma is cost-effective, but a better-performing biomarker to select low-risk women can maximize quality-adjusted outcomes.