Who is mastectomy most cost-effective for?
- For women diagnosed with BRCA1 and 2 gene mutations at any given age, prophylactic mastectomy was found not to be cost-effective due to limited survival benefits.
- For women diagnosed with BRCA1 and 2 gene mutations at the age of 60 or older and regardless of age of ovarian cancer diagnosis, prophylactic mastectomy was also found not be cost-effective due to limited survival benefits.
- For women diagnosed with BRCA1 and 2 gene mutations at the age of 40-50 and at least within 5 years following ovarian cancer diagnosis, prophylactic mastectomy was found to be cost-effective and associated with a survival benefit of 2-5 months over traditional screening methods.
“Our study provides clarity on how a woman’s age and timing of a risk-reducing mastectomy after an ovarian cancer diagnosis impact the benefit of this procedure. Within the first 5 years, nobody benefitted from risk-reducing mastectomy and after that threshold, survival gains were seen mostly in the youngest, healthiest ovarian cancer patients,” said Charlotte Gamble, lead author of the study and resident physician at Duke University School of Medicine. “Risk-reducing mastectomy is costly and can require many months of follow-up and recover. Our results emphasize that prophylactic mastectomy should be used selectively in women with both a BRCA mutation and a history of ovarian cancer,” noted Dr. Gamble.