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Prophylactic bilateral salpingo-oophorectomy (PBSO) with or without prophylactic bilateral mastectomy (PBM) or no intervention in BRCA1 mutation carriers: A cost-effectiveness analysis

Lookup NU author(s): Professor Sir John Burn

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Abstract

Women with germline BRCA1 mutation have a significant risk of breast and/or ovarian cancer. Prophylactic bilateral mastectomy (PBM) and prophylactic bilateral salpingo-oophorectomy (PBSO) prevent cancer in mutation carriers. The cost-effectiveness of PBSO (age of 35 years) with or without PBM five years earlier was compared to a no intervention setting employing a marginal cost analysis. National data on cancer incidence, mortality rates and costs were implemented together with observed Norwegian BRCA1 data in a Markov model and PBSO was assumed to reduce the risk of ovarian cancer by 90%. A 3% discount rate was used. The additional health care cost per mutation carrier undergoing PBSO and PBM was €15,784, and 6.4 discounted life years gained (LYG) was indicated (PBSO alone with 100% acceptance 3.1 LYG). The additional cost per LYG was €1973 (PBSO alone €1749/LYG). Including all resource use, the figure was a cost of €496 and €1284 per LYG, respectively. PBSO with or without PBM in BRCA1 mutation carriers is cost-effective. A testing of all incident breast cancers to identify mutation carrying families should be explored. © 2008 Elsevier Ltd. All rights reserved.


Publication metadata

Author(s): Norum J, Hagen AI, Maehle L, Apold J, Burn J, Moller P

Publication type: Article

Publication status: Published

Journal: European Journal of Cancer

Year: 2008

Volume: 44

Issue: 7

Pages: 963-971

ISSN (print): 0959-8049

ISSN (electronic): 1879-0852

Publisher: Pergamon

URL: http://dx.doi.org/10.1016/j.ejca.2008.02.025

DOI: 10.1016/j.ejca.2008.02.025


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