Resumen de Costo beneficio del estudio de diseminación en estadios I y II del cáncer de mama
Jamile Camacho N, Carolina Barriga, Paula Escobar O, Nicolás Seleme H, Rodrigo Schwartz
Chest X ray, abdominal ultrasound and bone scintigraphy are usually requested to study a possible dissemination of breast carcinoma. Aim: To study the yield and costs of these exams in the study of dissemination of stage I and II breast carcinoma. Material and methods: A retrospective analysis of patients operated for a breast carcinoma in a public surgical service. A chest X ray, abdominal ultrasound and bone scintigraphy was requested to all patients in the immediate postoperative period. Age, stage according to pathological TNM and costs per patient were registered. Results: Of 210 women operated, 40 were in stage I (19%) and 85 in stage II (41%). Dissemination study was negative in all stage I patients and in all but two patients in stage II. The yield for detection of distant metastases in these patients was 0.9% for chest X ray, 0% for abdominal ultrasound and 0.9% for bone scintigraphy. The total cost of the study, in Chilean pesos, was $10,369,620 in a public hospital and $16,535,400 in a private clinic. Discussion: Additional exams to detect distant metastases in early stages of breast carcinoma have a low yield and high costs (Rev Méd Chile 2003; 131: 155-8)
