Preoperative paravertebral blocks for the management of acute pain following mastectomy: a cost-effectiveness analysis.

Abstract:

PURPOSE:Preoperative paravertebral blocks (PPVBs) are routinely used for treating post-mastectomy pain, yet uncertainties remain about the cost-effectiveness of this modality. We aim to evaluate the cost-effectiveness of PPVBs at common willingness-to-pay (WTP) thresholds. METHODS:A decision analytic model compared two strategies: general anesthesia (GA) alone versus GA with multilevel PPVB. For the GA plus PPVB limb, patients were subjected to successful block placement versus varying severity of complications based on literature-derived probabilities. The need for rescue pain medication was the terminal node for all postoperative scenarios. Patient-reported pain scores sourced from published meta-analyses measured treatment effectiveness. Costing was derived from wholesale acquisition costs, the Medicare fee schedule, and publicly available hospital charge masters. Charges were converted to costs and adjusted for 2016 US dollars. A commercial payer perspective was adopted. Incremental cost-effectiveness ratios (ICERs) were evaluated against WTP thresholds of $500 and $50,000 for postoperative pain control. RESULTS:The ICER for preoperative paravertebral blocks was $154.49 per point reduction in pain score. 15% variation in inpatient costs resulted in ICER values ranging from $124.40-$180.66 per pain point score reduction. Altering the probability of block success by 5% generated ICER values of $144.71-$163.81 per pain score reduction. Probabilistic sensitivity analysis yielded cost-effective trials 69.43% of the time at $500 WTP thresholds. CONCLUSION:Over a broad range of probabilities, PPVB in mastectomy reduces postoperative pain at an acceptable incremental cost compared to GA. Commercial payers should be persuaded to reimburse this technique based on convincing evidence of cost-effectiveness.

authors

Offodile AC 2nd,Sheckter CC,Tucker A,Watzker A,Ottino K,Zammert M,Padula WV

doi

10.1007/s10549-017-4371-9

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

477-484

issue

3

eissn

0167-6806

issn

1573-7217

pii

10.1007/s10549-017-4371-9

journal_volume

165

pub_type

杂志文章,评审
  • Inflammatory breast cancer (IBC): clues for targeted therapies.

    abstract::Inflammatory breast cancer (IBC) is the most aggressive type of advanced breast cancer characterized by rapid proliferation, early metastatic development and poor prognosis. Since there are few preclinical models of IBC, there is a general lack of understanding of the complexity of the disease. Recently, we have devel...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-013-2600-4

    authors: Fernandez SV,Robertson FM,Pei J,Aburto-Chumpitaz L,Mu Z,Chu K,Alpaugh RK,Huang Y,Cao Y,Ye Z,Cai KQ,Boley KM,Klein-Szanto AJ,Devarajan K,Addya S,Cristofanilli M

    更新日期:2013-07-01 00:00:00

  • Prognosis in patients diagnosed with loco-regional failure of breast cancer: 34 years longitudinal data from the Stockholm-Gotland cancer registry.

    abstract:RATIONALE:Survival after loco-regional failure (LRF) of breast cancer was investigated at the population level. METHODS:Using the Stockholm cancer registry, 2698 patients diagnosed with LRF between 1980 and 2014 were identified and divided into three cohorts by year of LRF diagnosis. Post-relapse event-free survival (...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-018-4936-2

    authors: Falato C,Taylor SK,Szulkin R,Nordblom A,Eriksson L,Sofiadis A,Fredriksson I,Hartman J,Bergh J,Foukakis T

    更新日期:2018-12-01 00:00:00

  • Women with breast cancer report substantially more disease- and treatment-related side or late effects than registered by clinical oncologists: a cross-sectional study of a standard follow-up program in an oncological department.

    abstract:BACKGROUND:Follow-up after breast cancer treatment is standard due to the risk of development of new primary cancers and recurrent disease. The aim of the present study was to evaluate a standard follow-up program in an oncological department by assessing: (1) Symptoms or signs of new primary cancer or recurrent diseas...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-017-4301-x

    authors: Ellegaard MB,Grau C,Zachariae R,Jensen AB

    更新日期:2017-08-01 00:00:00

  • Transforming growth factorβ1 L10P variant plays an active role on the breast cancer susceptibility in Caucasian: evidence from 10,392 cases and 11,697 controls.

    abstract::In view of the essential role of transforming growth factorβ1 (TGFB1) on both inhibiting the development of early benign breast tumors as well as promoting tumor invasion, the association of TGFB1 L10P polymorphism and breast cancer risk has been widely reported, but results of previous studies were somewhat contradic...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章,meta分析,评审

    doi:10.1007/s10549-010-0843-x

    authors: Ma X,Chen C,Xiong H,Li Y

    更新日期:2010-11-01 00:00:00

  • TNF-alpha polymorphisms and breast cancer.

    abstract::Tumor necrosis factor-α (TNF-α) is an important pro-inflammatory cytokine in the development and progress in human cancer. TNF-α polymorphisms have been confirmed to influence the risk for several types of cancer, however, the associations between TNF-α polymorphisms and breast cancer (BC) remain controversial and amb...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章,meta分析,评审

    doi:10.1007/s10549-011-1494-2

    authors: Yang Y,Feng R,Bi S,Xu Y

    更新日期:2011-09-01 00:00:00

  • Novel triterpenoid 25-hydroxy-3-oxoolean-12-en-28-oic acid induces growth arrest and apoptosis in breast cancer cells.

    abstract::25-Hydroxy-3-oxoolean-12-en-28-oic acid (Amooranin-AMR) is a triterpene acid isolated from the stem bark of a tropical tree (Amoora rohituka) grown wild in India. A herbal preparation used for the treatment of cancer by the Ayurvedic system of medicine contains the stem bark of Amoora rohituka as one of the ingredient...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-006-9275-z

    authors: Rabi T,Wang L,Banerjee S

    更新日期:2007-01-01 00:00:00

  • Differences in prognosis and efficacy of chemotherapy by p53 expression in triple-negative breast cancer.

    abstract:PURPOSE:TP53 mutation is the most common mutation in breast cancer, and it is considered a target marker of triple-negative breast cancer (TNBC). We investigated whether expression of p53 detected by immunochemical staining predicts the chemotherapy response of TNBC. METHODS:A total of 11,393 TNBC patients who had bet...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-018-4928-2

    authors: Bae SY,Nam SJ,Jung Y,Lee SB,Park BW,Lim W,Jung SH,Yang HW,Jung SP

    更新日期:2018-11-01 00:00:00

  • Binding of lectins to human mammary tumors: ultrastructural study.

    abstract::The site of several lectin receptors in human mammary tumors and stroma was studied with the electron microscope. The advantage of the ultrastructural over light microscopic study was that lectin receptors could be localized with precision on the different cell types of the tumor and stroma. Eighteen human mammary car...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/BF01806482

    authors: Calafat J,Janssen H

    更新日期:1984-01-01 00:00:00

  • Predictors and outcomes of contralateral prophylactic mastectomy among breast cancer survivors.

    abstract:BACKGROUND:Women affected with breast cancer who carry a BRCA1 or BRCA2 (BRCA1/2) mutation are at risk of developing contralateral breast cancer. To reduce the risk of contralateral breast cancer, some patients opt for prophylactic surgery of the unaffected breast (contralateral prophylactic mastectomy, CPM) in additio...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-006-9423-5

    authors: Graves KD,Peshkin BN,Halbert CH,DeMarco TA,Isaacs C,Schwartz MD

    更新日期:2007-09-01 00:00:00

  • Molecular determinants of drug response in TNBC cell lines.

    abstract:PURPOSE:There is a need for biomarkers of drug efficacy for targeted therapies in triple-negative breast cancer (TNBC). As a step toward this, we identify multi-omic molecular determinants of anti-TNBC efficacy in cell lines for a panel of oncology drugs. METHODS:Using 23 TNBC cell lines, drug sensitivity scores (DSS3...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-019-05473-9

    authors: Merrill NM,Lachacz EJ,Vandecan NM,Ulintz PJ,Bao L,Lloyd JP,Yates JA,Morikawa A,Merajver SD,Soellner MB

    更新日期:2020-01-01 00:00:00

  • Concordance with BRCA1/2 testing guidelines among women in The Health of Women (HOW) Study®.

    abstract:PURPOSE:To evaluate factors associated with compliance to the National Comprehensive Cancer Network (NCCN) guidelines for BRCA1/2 testing and identify groups who are at risk of under- and over-use of BRCA1/2 testing. METHODS:Data included 20,758 women from Dr. Susan Love Research Foundation's The Health of Women (HOW)...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-018-5035-0

    authors: Silver MI,Klein W,Samimi G,Minasian L,Loud J,Roberts MC

    更新日期:2019-02-01 00:00:00

  • (-)-Epigallocatechin (EGC) of green tea induces apoptosis of human breast cancer cells but not of their normal counterparts.

    abstract::(-)-Epigallocatechin (EGC), one of green tea polyphenols, has been shown to inhibit growth of cancer cells. However its mechanism of action is poorly known. We show here that EGC strongly inhibited the growth of breast cancer cell lines (MCF-7 and MDA-MB-231) but not that of normal breast epithelial cells. The inhibit...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1023/a:1020833410523

    authors: Vergote D,Cren-Olivé C,Chopin V,Toillon RA,Rolando C,Hondermarck H,Le Bourhis X

    更新日期:2002-12-01 00:00:00

  • Mammographic breast density and the Gail model for breast cancer risk prediction in a screening population.

    abstract:BACKGROUND:Estimating an individual woman's absolute risk for breast cancer is essential for decision making about screening and preventive recommendations. Although the current standard, the Gail model, is well calibrated in populations, it performs poorly for individuals. Mammographic breast density (BD) may improve ...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-005-5152-4

    authors: Tice JA,Cummings SR,Ziv E,Kerlikowske K

    更新日期:2005-11-01 00:00:00

  • Digital compared to screen-film mammography: breast cancer prognostic features in an organized screening program.

    abstract::Our previous study found cancer detection rates were equivalent for direct radiography compared to screen-film mammography, while rates for computed radiography were significantly lower. This study compares prognostic features of invasive breast cancers by type of mammography. Approved by the University of Toronto Res...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-014-3088-2

    authors: Prummel MV,Done SJ,Muradali D,Majpruz V,Brown P,Jiang H,Shumak RS,Yaffe MJ,Holloway CM,Chiarelli AM

    更新日期:2014-09-01 00:00:00

  • A phase III randomized multicenter trial evaluating cognition in post-menopausal breast cancer patients receiving adjuvant hormonotherapy.

    abstract::Cognitive impairment, especially verbal episodic memory and executive function impairments, has been considered to be a possible adverse effect of aromatase inhibitors (AI). This phase III open-label study compared the impact of tamoxifen and AI on verbal episodic memory (Rey auditory verbal learning test-RAVLT) and o...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s10549-015-3493-1

    authors: Le Rhun E,Delbeuck X,Lefeuvre-Plesse C,Kramar A,Skrobala E,Pasquier F,Bonneterre J

    更新日期:2015-08-01 00:00:00

  • Radial scar on image-guided breast biopsy: is surgical excision necessary?

    abstract:PURPOSE:Radial scar's stellate appearance may mimic carcinoma mammographically and histologically. Management of radial scar (RS) found on breast core needle biopsies (CNB) ranges from excision to clinical observation due to the variation in reported upgrades to malignancy at surgical excision. We examined the upgrade ...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-018-4741-y

    authors: Chou WYY,Veis DJ,Aft R

    更新日期:2018-07-01 00:00:00

  • Protein S and protein C level changes with adjuvant tamoxifen therapy in postmenopausal women.

    abstract::Tamoxifen citrate is a synthetic antiestrogen that provides survival benefit when given as adjuvant treatment in postmenopausal women with breast cancer. Venous thrombophlebitis may complicate tamoxifen treatment at a rate of approximately one per 800 treatment-years. To explore the possible procoagulant effects assoc...

    journal_title:Breast cancer research and treatment

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF00665973

    authors: Mamby CC,Love RR,Feyzi JM

    更新日期:1994-01-01 00:00:00

  • Inhibition of growth and appearance of estrogen-dependent rat mammary tumors by 10-propargylestr-4-ene-3,17-dione, an aromatase inhibitor.

    abstract::The aromatase inhibitor 10-propargylestr-4-ene-3,17-dione (PED) has been evaluated in vivo as an anticancer agent. Prolonged administration of PED to rats bearing dimethylbenzanthracene-induced mammary tumors resulted in significant regression of hormone-responsive tumors within several days. Greater than 50% regressi...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/BF00682696

    authors: Zimniski SJ,Brandt ME,Covey DF,Puett D

    更新日期:1993-01-01 00:00:00

  • Use of dried blood spots for the determination of serum concentrations of tamoxifen and endoxifen.

    abstract::The anti-estrogenic effect of tamoxifen is suggested to be mainly attributable to its metabolite (Z)-endoxifen, and a minimum therapeutic threshold for (Z)-endoxifen in serum has been proposed. The objective of this research was to establish the relationship between dried blood spot (DBS) and serum concentrations of t...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-014-2999-2

    authors: Jager NG,Rosing H,Schellens JH,Beijnen JH,Linn SC

    更新日期:2014-07-01 00:00:00

  • Effect of the overexpression of BRCA2 unclassified missense variants on spontaneous homologous recombination in human cells.

    abstract::Breast Cancer 2 gene (BRCA2) mutation carriers have a 45% chance of developing breast cancer and a 11% risk of developing ovarian cancer by the age of 70. While hundreds of BRCA2-truncating mutations have been associated with an increased cancer risk in carriers, the contribution of unclassified variants (UCVs) to can...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-011-1607-y

    authors: Balia C,Galli A,Caligo MA

    更新日期:2011-10-01 00:00:00

  • Association between patient reported outcomes and quantitative sensory tests for measuring long-term neurotoxicity in breast cancer survivors treated with adjuvant paclitaxel chemotherapy.

    abstract::Neurotoxicity is a common side-effect during taxane therapy. The prevalence and severity of long-term neurotoxicity following therapy is unknown. The authors conducted a cross-sectional study of 50 consecutive patients with stage I-III BC, who were within 6 months and 2 years of completing adjuvant taxane therapy and ...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-010-1278-0

    authors: Hershman DL,Weimer LH,Wang A,Kranwinkel G,Brafman L,Fuentes D,Awad D,Crew KD

    更新日期:2011-02-01 00:00:00

  • A meta-analysis of gene expression-based biomarkers predicting outcome after tamoxifen treatment in breast cancer.

    abstract::To date, three molecular markers (ER, PR, and CYP2D6) have been used in clinical setting to predict the benefit of the anti-estrogen tamoxifen therapy. Our aim was to validate new biomarker candidates predicting response to tamoxifen treatment in breast cancer by evaluating these in a meta-analysis of available transc...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章,meta分析

    doi:10.1007/s10549-013-2622-y

    authors: Mihály Z,Kormos M,Lánczky A,Dank M,Budczies J,Szász MA,Győrffy B

    更新日期:2013-07-01 00:00:00

  • Overexpression of a novel cell cycle regulator ecdysoneless in breast cancer: a marker of poor prognosis in HER2/neu-overexpressing breast cancer patients.

    abstract::Uncontrolled proliferation is one of the hallmarks of breast cancer. We have previously identified the human Ecd protein (human ortholog of Drosophila Ecdysoneless, hereafter called Ecd) as a novel promoter of mammalian cell cycle progression, a function related to its ability to remove the repressive effects of Rb-fa...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-011-1946-8

    authors: Zhao X,Mirza S,Alshareeda A,Zhang Y,Gurumurthy CB,Bele A,Kim JH,Mohibi S,Goswami M,Lele SM,West W,Qiu F,Ellis IO,Rakha EA,Green AR,Band H,Band V

    更新日期:2012-07-01 00:00:00

  • Differential retention of rhodamine 123 by breast carcinoma and normal human mammary tissue.

    abstract::We have qualitatively evaluated the retention of the fluorescent dye rhodamine 123 by malignant or non-malignant breast epithelial cells in passively-infused fresh surgical specimens. Our findings demonstrate a microscopically-visible increase in the ability of primary and metastatic tumor cells to retain the dye, as ...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/BF01975444

    authors: Dairkee SH,Hackett AJ

    更新日期:1991-03-01 00:00:00

  • Characterization of bipotent mammary epithelial progenitor cells in normal adult human breast tissue.

    abstract::The purpose of the present study was to characterize primitive epithelial progenitor populations present in adult normal human mammary tissue using a combination of flow cytometry and in vitro colony assay procedures. Three types of human breast epithelial cell (HBEC) progenitors were identified: luminal-restricted, m...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1023/a:1010615124301

    authors: Stingl J,Eaves CJ,Zandieh I,Emerman JT

    更新日期:2001-05-01 00:00:00

  • The association between diabetes and breast cancer stage at diagnosis: a population-based study.

    abstract::Women with diabetes have higher breast cancer incidence and mortality. The purpose of this study was to examine the impact of diabetes on stage at breast cancer diagnosis, as a possible reason for their higher mortality. Using population-based health databases from Ontario, Canada, this retrospective cohort study exam...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-015-3323-5

    authors: Lipscombe LL,Fischer HD,Austin PC,Fu L,Jaakkimainen RL,Ginsburg O,Rochon PA,Narod S,Paszat L

    更新日期:2015-04-01 00:00:00

  • Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer.

    abstract::Identifying risk factors for lymphedema in patients treated for breast cancer has become increasingly important, given the current lack of standardization surrounding diagnosis and treatment. Reports on the association of body mass index (BMI) and weight change with lymphedema risk are conflicting. We sought to examin...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-013-2715-7

    authors: Jammallo LS,Miller CL,Singer M,Horick NK,Skolny MN,Specht MC,O'Toole J,Taghian AG

    更新日期:2013-11-01 00:00:00

  • HITS-CLIP reveals key regulators of nuclear receptor signaling in breast cancer.

    abstract::miRNAs regulate the expression of genes in both normal physiology and disease. While miRNAs have been demonstrated to play a pivotal role in aspects of cancer biology, these reports have generally focused on the regulation of single genes. Such single-gene approaches have significant limitations, relying on miRNA expr...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1007/s10549-014-3004-9

    authors: Pillai MM,Gillen AE,Yamamoto TM,Kline E,Brown J,Flory K,Hesselberth JR,Kabos P

    更新日期:2014-07-01 00:00:00

  • Enumeration of circulating tumor cells in the blood of breast cancer patients after filtration enrichment: correlation with disease stage.

    abstract::The biological and clinical significance of circulating tumor cells (CTC) in the peripheral blood of breast cancer patients is not known. To study this question, we used a direct visualization assay to correlate the number of CTC with disease stage and progression. The CTC were enriched from the nucleated cell fractio...

    journal_title:Breast cancer research and treatment

    pub_type: 杂志文章

    doi:10.1023/B:BREA.0000036897.92513.72

    authors: Kahn HJ,Presta A,Yang LY,Blondal J,Trudeau M,Lickley L,Holloway C,McCready DR,Maclean D,Marks A

    更新日期:2004-08-01 00:00:00

  • Factors predicting the sentinel and non-sentinel lymph node metastases in breast cancer.

    abstract::The sentinel lymph node (SLN) is the only focus of axillary metastasis in a significant proportion of patients. In this single institutional study, clinicopathologic characteristics were investigated to determine the factors predicting the status of a SLN biopsy and the metastatic involvement of non-SLNs. Data were re...

    journal_title:Breast cancer research and treatment

    pub_type: 临床试验,杂志文章

    doi:10.1007/s10549-005-9007-9

    authors: Ozmen V,Karanlik H,Cabioglu N,Igci A,Kecer M,Asoglu O,Tuzlali S,Mudun A

    更新日期:2006-01-01 00:00:00