Researchers found that women who have been treated for early-stage breast cancer and who no longer show symptoms are often advised to undergo advanced imaging and biomarker tests that have been proven unnecessary, could potentially be more harmful than beneficial, and could cost patients a significant amount of money.
The study was led by researchers at the Fred Hutchinson Cancer Research Center and will be presented at the American Society of Clinical Oncology (ASCO) 2017 Annual Meeting (June 2-6) on June 5 in Chicago.
The poster presentation is titled “Patterns in provider types and cost of surveillance testing in early-stage breast cancer patients: A regional study.”
The study linked cancer registry patient records in western Washington state with claims from the commercial insurers Premera and Regence.
“Although ASCO Choosing Wisely guidelines recommend against routine surveillance testing, including advanced imaging for asymptomatic individuals with early-stage breast cancer who have undergone treatment, these costly procedures are frequently performed,” Gary Lyman, co-director of the Hutchinson Institute for Cancer Outcomes Research and the study’s lead author, said in a press release.
The ASCO guidelines were created to assist patients and their oncologists make more informed decisions regarding treatment options based on the latest medical evidence. Importantly, these guidelines recommend against what is being observed: the routine use of advanced imaging analysis and costly tests to track tumor markers.
The ASCO guidelines were based on several studies that demonstrated these tests bring no proven benefit to these patients and can even lead to additional, unneeded procedures when there are false-positive results, as well as unnecessary radiation exposure, misdiagnosis, and potential overtreatment.
In the study to be presented at ASCO 2017, researchers reviewed records of 2,193 early-stage breast cancer patients and found that 37 percent received tumor-marker tests in their post-treatment surveillance period — an average of 2.8 tests per patient — and 17 percent received advanced imaging: an average of 1.5 images per patient.
Lyman’s research helped formulate the ASCO guidelines as well as other evidence-based documents. He said the financial burden observed in his studies averaged $18,403 during the surveillance period alone.
“During early surveillance following treatment, patients averaged 13.3 physician visits, primarily with oncologists and primary care providers,” he said. “We believe one of the best ways we can help patients reduce their financial burden is for us to reinforce the message with oncologists that these tests have been shown to provide no benefit for this particular group of patients.”