High Reoperation Rates, Costs After Initial Breast-Conserving Surgery in Women With Breast Cancer

Reoperation rates for women who had initial breast conserving surgery (BCS) reached 21.1% among those who were commercially insured, and 14.9% among those on Medicare, a recent study found. These reoperations, the study results indicated, were associated with a 24% increase in costs among both cohorts.

In their retrospective cohort study, researchers used commercial insurance data and Medicare fee-for-service claims data to gain insights into reoperation rates and associated health care costs for patients undergoing BCS. Using this data, researchers identified 17,129 commercially insured women 18 to 64 years of age and 6977 Medicare beneficiaries 18 years of age and older who had initial BCS between 2017 and 2019.

Researchers looked at reoperation rates within 1 year of the initial BCS and measured overall health care costs at 1 year by stratifying reoperation status.

The results of the study indicated that at 1-year follow-up, 21.1% of commercially insured women had undergone reoperation (95% CI; 20.5% to 21.8%) while 14.9% underwent reoperation among the Medicare cohort (95% CI; 14.1% to 15.7%).

The mean costs associated with the initial BCS at 1 year of follow-up was $95,165 for the commercial cohort and $36,313 for the Medicare cohort. These reoperations were associated with a 24% increase in costs for both the cohorts, which translated to incremental expenses of $21,607 and $8559, respectively, according to the results of the study.

Additionally, reoperations were linked to an increased risk of complications: a 54% increased risk in the commercial cohort and an 89% increased risk in the Medicare cohort.

“The rates of reoperation after BCS have remained high and have contributed to increased health care costs,” the authors concluded. “Continuing efforts to reduce reoperation need more attention.”

Reference:
Kim Y, Ganduglia-Cazaban C, Tamirisa N, Lucci A, Krause TM. Contemporary analysis of reexcision and conversion to mastectomy rates and associated healthcare costs for women undergoing breast-conserving surgery. Ann Surg Oncol. Published online February 6, 2024. doi:10.1245/s10434-024-14902-z