The specialized nurses track to reduce the cost of care after breast cancer

Monitoring of women treated for breast cancer early stage would be less costly if entrusted to nurses training their patients to detect recurrence, according to results of a Swedish study presented at the 6th European Conference on breast cancer (EBCC-6) in Berlin (Germany)
Examinations of breast cancer
Monitoring of women treated for breast cancer early by surgery and adjuvant therapy begins to ask questions in terms of organization. Given the frequency of cancer and scalability of organized screening, the oncologists are beginning to worry about not having enough time to follow all the women involved.

Inga Lill Koinberg, nurse and doctor in Varberg Hospital and the University of Kristianstad, Sweden, reported the results of a study of 264 women treated for breast cancer stage I or II, with surgery and radiotherapy, and were followed by either a doctor or a nurse specialist.

In the group of patients followed by a doctor, the women had regular checkups with four visits per year during the first two years, and then twice a year to five years and then once a year.

In the group of women followed by nurses, patients saw the nurse three months after their initial visit with the doctor at the end of radiotherapy. They were trained to detect a recurrence in the breast, the skin, axillary nodes and scar and could call the nurse if they had any questions or symptoms of recurrence. They also enjoyed an annual mammogram and joined the organized screening program after three years.

Apart from a small gap all, no measured difference
The authors of this study found no difference in terms of anxiety, depression, satisfaction with care, access to medical center and especially rate of recurrence and mortality.

However, the cost of monitoring for five years was 630 euros per person per year for women followed by a doctor and 495 euros for those who saw a specialist nurse. The intervention of the nurse with full demand balance was 20% less expensive than routine visits to the doctor. The largest economy was performed on doctor visits.

On the five-year period, this represents a "modest" difference per patient but multiplied by the number of women involved, can represent up € 4.1 million per year for Sweden, the authors calculated.

Dr. Koinberg said at a press conference of the Congress that it was important to look at the organization of the monitoring of women treated for breast cancer early. They come in just about all in a monitoring program for five years, very resource-consuming. However, these resources could be directed to other parts of the support.