{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T16:28:17Z","timestamp":1793636897068,"version":"4.5.1"},"reference-count":61,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T00:00:00Z","timestamp":1693008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Breast cancer (BC) treatment is rapidly evolving with new and costly therapeutics. Existing costing models have a limited ability to capture current treatment costs. We used an Activity-Based Costing (ABC) method to determine a per-case cost for BC treatment by stage and molecular subtype. Methods: ABC was used to proportionally integrate multidisciplinary evidence-based patient and provider treatment options for BC, yielding a per-case cost for the total duration of treatment by stage and molecular subtype. Diagnostic imaging, pathology, surgery, radiation therapy, systemic therapy, inpatient, emergency, home care and palliative care costs were included. Results: BC treatment costs were higher than noted in previous studies and varied widely by molecular subtype. Cost increased exponentially with the stage of disease. The per-case cost for treatment (2023C$) for DCIS was C$ 14,505, and the mean costs for all subtypes were C$ 39,263, C$ 76,446, C$ 97,668 and C$ 370,398 for stage I, II, III and IV BC, respectively. Stage IV costs were as high as C$ 516,415 per case. When weighted by the proportion of molecular subtype in the population, case costs were C$ 31,749, C$ 66,758, C$ 111,368 and C$ 289,598 for stage I, II, III and IV BC, respectively. The magnitude of cost differential was up to 10.9 times for stage IV compared to stage I, 4.4 times for stage III compared to stage I and 35.6 times for stage IV compared to DCIS. Conclusion: The cost of BC treatment is rapidly escalating with novel therapies and increasing survival, resulting in an exponential increase in treatment costs for later-stage disease. We provide real-time, case-based costing for BC treatment which will allow for the assessment of health system economic impacts and an accurate understanding of the cost-effectiveness of screening.<\/jats:p>","DOI":"10.3390\/curroncol30090571","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T06:57:35Z","timestamp":1693205855000},"page":"7860-7873","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Capturing the True Cost of Breast Cancer Treatment: Molecular Subtype and Stage-Specific per-Case Activity-Based Costing"],"prefix":"10.3390","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5422-8428","authenticated-orcid":false,"given":"Anna N.","family":"Wilkinson","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0367-2219","authenticated-orcid":false,"given":"Jean M.","family":"Seely","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira","family":"Rushton","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital Cancer Centre, 501 Smyth Rd., Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Anatomic Pathology, The Ottawa Hospital, 501 Smyth Rd., Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Cordeiro","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Allard-Coutu","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole J.","family":"Look Hong","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikitha","family":"Moideen","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital Cancer Centre, 501 Smyth Rd., Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Robinson","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital Cancer Centre, 501 Smyth Rd., Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5021-972X","authenticated-orcid":false,"given":"Julie","family":"Renaud","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital Cancer Centre, 501 Smyth Rd., Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5479-1280","authenticated-orcid":false,"given":"James G.","family":"Mainprize","sequence":"additional","affiliation":[{"name":"Department of Medical Biophysics, University of Toronto, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-9915","authenticated-orcid":false,"given":"Martin J.","family":"Yaffe","sequence":"additional","affiliation":[{"name":"Department of Medical Biophysics, University of Toronto, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E601","DOI":"10.1503\/cmaj.212097","article-title":"Projected estimates of cancer in Canada in 2022","volume":"194","author":"Brenner","year":"2022","journal-title":"CMAJ"},{"key":"ref_2","unstructured":"Lee, S., and Breast Cancer Statistics (2023, June 23). 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