clinical dissemination results. The results show that use of lumpectomy increased significantly from 35.2% to 42.4%, in 1990. Lumpectomy was the treatment choice for younger women, patients with private health insurance, absence of axillary node metastasises, and treatment in urban hospitals. On the other hand, only 45.3% of women with Medicaid coverage who had a lumpectomy with radiation therapy, compared with 77.5% of private insurance subscribers and 88.1% of Medicare beneficiaries in Pennsylvania. This finding is troubling even though there was substantially more compliance in the later years of the study, with 60.0% of eligible Medicaid beneficiaries receiving follow-up radiation therapy in 1990. There was an important variation in the use of radiation therapy depending on the insurance type of patients. A study done by Norum et. al. [15] in 1997 performed cost utility and cost minimization analysis for comparison of lumpectomy and mastectomy in Norway. The cost of treatment for every single lumpectomy patients was 9564$ and for mastectomy patients was …show more content…
5596$. Using the quality of life gain for lumpectomy was 0.03 and 5% discount rate, the cost gained per QALY calculated in lumpectomy compared with mastectomy. The value was 20508$. In cost-minimizing analysis results indicate that, lumpectomy had a cost of 10748$ and mastectomy followed by reconstructive surgery had a cost of 8538$. In economic terms for both analyses, lumpectomy was expensive than mastectomy. Hayman et. al. [16] in 1998 analysed cost effectiveness of radiation therapy following conservative surgery for early-stage breast cancer. They used Markov model, a costutility analysis was performed to compare a strategy of radiation therapy versus no radiation therapy in following conservative surgery. Local recurrence, distant recurrence, and survival rates used in the model. Utilities for the no metastatic health states were obtained from actual patients. Using the data from a single institution they estimated direct medical costs, transportation and time costs. ICER over a ten years’ time horizon were calculated by the model for each strategy. The ICER indicate that 11 28000$ per QALY gained for patients had a radiation therapy when compared with patients with no radiation therapy. The threshold they used for determining the cost effectiveness of radiation therapy was 50000$ per QALY gained, based on this assumption radiation therapy was cost-effective care compared with other accepted medical interventions. In general, physicians recommend a treatment according to their past experiences and survival of patient not the quality of life after surgery.
Women are more likely to undergo lumpectomy surgery if their physicians graduated from medical school after 1981 compared with the physicians graduated from medical school after 1961. According to a study done by Kotwall et. al. [17] examined the 157 hospital located in North Carolina. Using multiple logistic regression they calculated the yearly prevalence of lumpectomy in order to determine tumor, patient, and surgeon factors associated with lumpectomy. They conclude that woman younger than 50 years old and with small tumors operated by younger surgeons were more likely to undergo lumpectomy. The reason is that the surgeons trained after 1981 were trained to do lumpectomy surgery and are more knowledgeable about the research showing the safety of
lumpectomy. The study done by Whelan et. al. [18] in 1999, developed a Decision Board to improve communication decision making. The Decision Board was administered to 175 patients. The board give information to women early stage breast cancer about risk and benefits of mastectomy and lumpectomy. From different communities, seven surgeons administered the instrument to women with newly diagnosed clinical stage I or II breast cancer over an 18-month period. Patients and surgeons were interviewed regarding acceptability of the instrument. More patients who used the Decision Board were very satisfied with the information exchanged and the decision-making process. Almost all patients felt they were offered a clear choice. Surgeons also reported similar high satisfaction and comfort with administration of the instrument. The results reported that Decision Board is applicable to present information about patients in 91% consultant. The rate of lumpectomy decreased from 88% to %73 when Decision Board was introduced. The observed results were unexpected. However, the reason of decreasing the lumpectomy rate was some women wanted to avoid radiation therap
Breast cancer was and still is the leading cause of death in women in the United States , and Dr. Halsted's number one goal was to reduce reoccurrence. He believed that the most effective way to reach this goal was to uproot the cancerous cells in the breasts, thus giving it its name "radical" mastectomy. The original mastectomy involved only removing the cancerous tumor, known today as a lumpectomy. After the aggressive disease returned, Halsted decided to remove the breast entirely. Frustrated with his negative results, he begins a tour through Europe to learn from some of the biggest names in surgery during the late 1800's throughout the early 1900's. Halsted wanted to keep cancer from taking over the body yet again. During his time in Europe, he witnesses his fellow surgeon, Volkmann, remo...
Surgery is the most common treatment for all stages of colon cancer. Cancer cells may be removed by one of the below procedures:
Rachel was 40 years old when she moved from India to USA with her husband and four kids to fulfill their American dreams. She knew little english and had great difficulty fitting into the new environment in America. She was unable to work because she had to take care of her 10- month-old daughter. Her husband, who was a lawyer in India, was now working at Forman Mills for minimum wage. Recently, Rachel was diagnosed with stage II breast cancer. Her doctors said her tumor is almost seven years old and if she has routine check ups, her survival rate will be higher. Rachel did not have a health insurance and because of this, she postponed necessary care and avoided preventive care. Even though she gets basic treatments from Public Healthcare Center it is not enough for this chronic disease. Her family is helpless; if her husband took insurance coverage from workplace there would be little money left for their daily expenses after paying for insurance premiums. Her husband is now planning to take another job so he can take workplace insurance and save his wife.
Over the past decade breast cancer has become one of the most predominant diseases in the United States. Breast cancer starts out as a malignant tumor in the tissues of the breast which is formed from the uncontrolled growth of abnormal breast cells. Breast cancer is the most common cancer in women, but it can also appear in men. (Stephan, 2010)
Surgical Oncology is a subset of oncology that focuses on the surgical management of cancer. Though, it has not been ratified by a Board certification, this area of expertise is coming to its own by the success of combined treatment with chemotherapy, radiation, and targeted biological treatments. Through developing technology, such as the iKnife, surgery to target tumorous cells is becoming a necessary and popular field of medicine and is a very viable option for cancer procedures, both for treatment and prevention. This paper will explore the probability of a breast cancer patient undergoing more than one surgery given that surgery is the best treatment option. The purpose of this investigation is to determine the effectiveness and accuracy of breast cancer operations in completely eliminating tumorous cells based on size of tumor and location/accessibility. By no means is this a medically sponsored or medically recommended paper and the exploration should be read with this in mind.
As modern humans, we understand that the quality of our health is affected by the negative impacts, such as air pollution, water and food. Science is developing in much faster way but at the same time number of problems are also arising. Problems like infectious diseases, diseases without any treatment or whose treatments are available up to a lesser extent such as Lung cancer, prostate cancer, skin cancer, ovarian cancer, pancreatic cancer, penile cancer etc. Cancer is responsible for one in seven deaths. It is epidemic disease thefore its consequences can be seen worldwide. More than twelve million new cases diagnosed yearly and the rate is increasing much faster (Hegde, j.j. 2009). Large number of patients die after developing cancer despite the availabity of various treatments, therefore there is a increase demand for a developing new approaches to cancer therapy. There are number of treatments available but the problem is that they have number of side effects, disturbance or effect on the norm...
Every woman has her own reasons behind her decision to get breast implants. Some women have undergone mastectomies, and get breast implants in order to feel “normal” again. According to the National Women’s Health Network (http://www.womenshealthnetwork.org) women who have lumpectomies have the same survival rate of women who have mastectomies as a result of breast cancer. They concluded that up to 40 percent of women who were diagnosed with breast cancer underwent unnecessary mastectomies. These mastectomies, whether necessary or not may lead to women to undergo breast augmentation surgery.
Yadav, B. S., Sharma, S. C., Menu, G., Mohmad, A., Patel, F. D., Nisar, K., & Sushmita, G. (2010). Pattern of care and survival in older women with breast cancer in india. Journal of Radiotherapy in Practice, 9(4), 237-245. doi:http://dx.doi.org/10.1017/S1460396909990239
Some risk factors cannot be changed such as age, race, and gender. A person 's risk increases as they get older. Approximately 1 out of 8 women are at risk of developing breast cancer are younger than 55. Approximately 2 out of 3 women are at risk of developing breast cancer who are older than 55 (American Cancer Society, 2014). To decrease this rate, women need more timely follow ups and access to high quality treatments (Centers for Disease Control and Prevention, 2015). Men can develop breast cancer, but this disease is more common among women than men. (American Cancer Society, 2015).
According to Breast Cancer Statistics, Breast cancer usually occurs in women between the ages of 35 and 65, even though fifty percent of all breast cancer is of women sixty-five and older (Breast Cancer Statistics, 2008). Although the cause of cancer is unknown, there are factors that increase the chances of getting it. These facto...
Socioeconomic factors such, as inadequate screening are the reason for the African American women being diagnosed in the later stages. Screening such as mammograms is to catch breast cancer at an early age but data indicates that African American women tend to wait till it’s too late to receive this because of lack of insurance.
Skravanek, P. (1988). The debate over mass mammography in Britain: Br Med J; 297: 1542.
Though Canadian’s have more access to primary health care, certain health treatments of chronic diseases such as cancer are superior in the United States. The United States on average has an additional “five year survival rate compared to Canadians” because the cancer screening rates are much higher. This is why the United States has the highest breast cancer survival rate in the world (Abernethy, 2010). It is important to remember, nevertheless, that though this is a major positive to America’s health care system, Canada has an
For example, for the antithrombotic guideline, the systematic review on utilities suggested that major bleeding was equivalent to nonfatal pulmonary embolism; while intracranial bleed overall was 2 to 3 times worse than major bleed or pulmonary embolism [37]. In the Breast Lump guidelines we found that recurrence and metastasis are the most important outcomes for women, and were considered as such by the panel [36].
Historically speaking breast cancer has been around for hundreds of years. Thankfully the treatment has improved. Patients who get the cancer removed and take care of themselves after, for example, by exercising and eating healthy, will live longer. There are many risks that increase the likelihood of developing breast cancer, for instance, age, family history, and race. A women who made history with breast cancer was Betty Ford, Betty was one of the first lady’s to speak openly about her disease. Betty encouraged women who have been affected with the disease to go to their doctor as soon as possible and told women who had shared that they didn’t have breast cancer to do self breast exams regularly and get mammograms. She also said when women get diagnosed with it don’t be embarrassed. Treatments in the past were pretty good and quite the same compared to the treatments given to people now, for instance, mastectomy’s which was the primary...