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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2015

01-10-2015 | Clinical trial

Economic impact of 21-gene recurrence score testing on early-stage breast cancer in Ireland

Authors: Lillian Smyth, Geoff Watson, Elaine M. Walsh, Catherine M. Kelly, Maccon Keane, M. John Kennedy, Liam Grogan, Bryan T. Hennessy, Seamus O’Reilly, Linda E. Coate, Miriam O’Connor, Cecily Quinn, Katharina Verleger, Olaf Schoeman, Susan O’Reilly, Janice M. Walshe

Published in: Breast Cancer Research and Treatment | Issue 3/2015

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Abstract

The 21-gene test is a validated multi-gene diagnostic test that predicts chemotherapy (CT) benefit in oestrogen receptor positive (ER+), lymph node-negative (N0) breast cancer (BC) patients (pts). Ireland was the first public health care system to reimburse this test in Europe. Study objectives were to assess the impact of this test on decision-making and to analyse the economic impact of testing. Between October 2011 and February 2013, a national, retrospective, cross-sectional observational study of ER+, N0 BC pts tested with the 21-gene test was conducted. Surveyed breast medical oncologists, provided the assumption for the decision impact analysis that grade (G) 1 pts would not have received CT before testing and G2/3 pts would have received CT before testing. Descriptive statistical analyses were performed. 592 pts were identified; Low, intermediate and high recurrence score were identified in 53, 36 and 10 % pts, respectively. 384 (70 %) pts had G2, 129 (22 %) G3 and 76 (13 %) G1 tumours. Post testing, 345 pts (59 %) experienced a change in CT decision; 339 changed to hormone therapy alone and 6 advised to receive CT. 172 (30 %) pts received CT, 12 (3.9 %) of pts with low scores, 108 (50.9 %) of intermediate risk and 50 (90.9 %) of pts with high risk scores. Net reduction in CT use was 58 % and net savings achieved were €793,565. Since public reimbursement, the introduction of the 21-gene test has resulted in a significant reduction in chemotherapy administration and cost savings for the Irish public healthcare system.
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Metadata
Title
Economic impact of 21-gene recurrence score testing on early-stage breast cancer in Ireland
Authors
Lillian Smyth
Geoff Watson
Elaine M. Walsh
Catherine M. Kelly
Maccon Keane
M. John Kennedy
Liam Grogan
Bryan T. Hennessy
Seamus O’Reilly
Linda E. Coate
Miriam O’Connor
Cecily Quinn
Katharina Verleger
Olaf Schoeman
Susan O’Reilly
Janice M. Walshe
Publication date
01-10-2015
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2015
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-015-3555-4

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