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- W2488130123 abstract "Abstract Background Obtaining precise histopathologic detail for breast lumpectomy specimens is challenging due to extensive sampling and loss of 3-dimensional conformation with conventional methods. Whole-mount (WM) technique is a method of serial pathologic sectioning designed to maximize cross-sectional visualization, and enhance evaluation of margin status. Methods A decision analytic model was used to create a budget impact analysis comparing costs and outcomes for conventional processing and WM technique for breast lumpectomy specimens. Outcomes included additional operations, time required for processing and pathology interpretation, and the number of slides produced. Cost trade-offs were compared using incremental cost-effectiveness ratios, and a 3-year cost forecast was generated to estimate institutional expenditures required for variable adoption of the WM process. Deterministic and probabilistic sensitivity analyses were performed. Costs are reported in Canadian dollars and are 2014 appraisals. Results WM technique has a higher mean cost per patient ($3218) compared to conventional processing ($1414) and generates 19% more operations due to detection of positive margins. The number of pathology slides produced and pathologist hours required for interpretation were reduced with WM technique. WM costs an additional $9495 per extra operation completed but is forecasted to save approximately 1200 pathologist work hours over 3 years. The model was robust to tested ranges and most sensitive to changes in positive margin prevalence. Conclusion The initiation of routine WM processing for breast lumpectomy specimens is costly. However, favourable tradeoffs in diagnostic accuracy and histopathologic efficiency underpin the need to deliberately consider the adoption of WM technique." @default.
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- W2488130123 date "2016-09-01" @default.
- W2488130123 modified "2023-09-28" @default.
- W2488130123 title "The cost of accuracy: A budget impact analysis of whole-mount histopathology processing for patients with breast cancer undergoing breast conservation" @default.
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- W2488130123 doi "https://doi.org/10.1016/j.jcpo.2016.07.002" @default.
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