Breast Cancer Surgery Package "Can we Predetermine the Cost"

Diagnosis of Breast cancer is hard enough, without considering the direct and indirect costs associated with breast cancer treatment. Beating your cancer is patient’s first priority, but financial worries are often not far behind. Most breast cancer patients fail to understand, why package cost for breast treatment cannot be predetermine.

The answer is simple cost of treating breast cancer can vary from Rs. 1Lac to Rs. 10 Lacs. Cost Variation depends on the Stage of the Disease (Early / locally advanced / metastatic), Nutritional Status of the Patient, Individual Body and Immune Responses, Other Associated Diseases of any Organ of the Body (heart, lung, liver, kidney, diabetics, high blood pressure etc.), Modality(ies) of treatment required and best suited treatment plan as per National and International guidelines recommended during Tumour Board evaluation.

One has to consider the following scenarios.

Does the Patient require SURGERY? If yes,

* Whether only lump will be removed / entire breast will be removed?
* Will removal of breast be followed by reconstruction of breast?
* What kind of breast reconstruction is preferred by the patient?
* Will patient require breast prosthesis or not?

Following surgery, will the patient require Chemotherapy? If yes,

* What drugs will be used?
* Will the patient get chemotherapy in day care or will be hospitalization?

The cost will also depend on what kind of chemo drugs are recommended, based on the histology of the tumour. Some chemo drugs have to be imported and are very expensive.

First line of drugs may / may not produce desired results second / third line chemo drugs and targeted therapies are more expensive.

Radiation therapy may / may not be required. If it is required, is the patient mobile to come to hospital on OPD basis. If the patient is immobile additional cost of 6 weeks of hospitalization will be required. Depending on the category of room chosen by the patient, cost will be different for different categories of rooms.

If these patients also have other associated diseases e.g. Diabetes, High Blood Pressure Heart Disease,, Asthma, Bronchitis, Bronchiectasis , Liver Disease, Kidney Disease requiring dialysis or any other disease, the cost of repeated investigations, drugs, disposables minor medical or surgical procedures gets added to the treatment cost.

Patients of stage IV breast cancer do not require surgery (except cosmetic surgery in fungating ulcers of the breast) However, they do require long term supportive chemotherapy. If they do not respond to first line of drugs 2nd or 3rd line of drugs are also tried to control the disease.

In addition to chemotherapy they may need Blood / Blood Component Therapy, Parenteral Nutrition Therapy, Treatment of Metastatic Fractures Rehabilitation of the Patient etc.

In view of the above, patient must undergo a complete diagnostic workup with numerous investigations to confirm the cancer; this is followed by staging work up to find out the stage of the disease. After knowing the stage of the disease and modalities of treatment require done can give the estimated cost of surgery, Radiation, Chemotherapy, Supportive care, rehabilitation etc.

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