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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/18993

Title: A Comparison of the Costs of Sentinel Lymph Node Biopsy and of Axillary lymph Node Dissection in the Management of Early-stage Breast Cancer in Ontario
Authors: Wells, Bryan John
Advisor: Coyte, Peter C.
Quan, May Lynn
Department: Health Policy, Management and Evaluation
Keywords: Sentinel lymph node biopsy
breast cancer
cost-minimization analysis
decision analysis
axillary lymph node dissection
Issue Date: 17-Feb-2010
Abstract: Objective: To complete a cost-minimization analysis (CMA) of the cost of sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) in the management of early-stage breast cancer (ESBC) in a hypothetical Ontario hospital setting. Methods: Decision-analysis modeling, with a decision-tree and Markov states, was used to estimate hospital costs for the two treatment options. The model was populated with data from the literature and costs from the Ontario Case Costing Initiative, a publicly accessible, government-sponsored, costing database. Model variability and parameter uncertainty were quantified by probabilistic sensitivity analysis (PSA). Results: The SLNB treatment algorithm was cost-minimizing compared to the ALND-only treatment option. The costs of treating postoperative complications did not contribute to the incremental average cost. Conclusion: A treatment algorithm that involves SLNB as the initial axillary-staging procedure in the setting of ESBC offers a cost-savings over the ALND-only option. This result is generalizable to all Ontario hospitals.
URI: http://hdl.handle.net/1807/18993
Appears in Collections:Master
The Institute of Health Policy, Management and Evaluation - Master theses

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