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Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study

The risk of relapse for early breast cancer (BC) patients persists even after decades and to date, no specific and sensitive effective circulating biomarker for recurrence prediction has been identified yet. The international guidelines do not recommend the assessment of the serum tumor markers CEA...

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Autores principales: Maltoni, Roberta, Balzi, William, Rossi, Tania, Fabbri, Francesco, Bravaccini, Sara, Montella, Maria Teresa, Massa, Ilaria, Bertoni, Lucia, Falcini, Fabio, Altini, Mattia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870402/
https://www.ncbi.nlm.nih.gov/pubmed/35200539
http://dx.doi.org/10.3390/curroncol29020039
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author Maltoni, Roberta
Balzi, William
Rossi, Tania
Fabbri, Francesco
Bravaccini, Sara
Montella, Maria Teresa
Massa, Ilaria
Bertoni, Lucia
Falcini, Fabio
Altini, Mattia
author_facet Maltoni, Roberta
Balzi, William
Rossi, Tania
Fabbri, Francesco
Bravaccini, Sara
Montella, Maria Teresa
Massa, Ilaria
Bertoni, Lucia
Falcini, Fabio
Altini, Mattia
author_sort Maltoni, Roberta
collection PubMed
description The risk of relapse for early breast cancer (BC) patients persists even after decades and to date, no specific and sensitive effective circulating biomarker for recurrence prediction has been identified yet. The international guidelines do not recommend the assessment of the serum tumor markers CEA and CA15-3 in the follow-up of asymptomatic early BC patients. In our institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, as part of the E.Pic.A study, which was designed to assess the economic appropriateness of integrated care pathways in early BC, the use of CEA and CA15-3 as circulating tumor biomarkers in early BC patients was evaluated in 1502 patients one year after surgery, from 2015 to 2018, with an overall expense of EUR 51,764. A total of EUR 47,780 (92%) was used for execution of circulating tumor markers in early BC patients with stage 0, I and II tumors, neglecting the current guidelines and considered inappropriate by our professional board. We found that no patients with stage I BC experienced relapse in the 365 days after surgery, and in any case examination of the circulating markers CEA and CA15-3 was considered crucial for diagnosis of relapse. Our findings suggest that this inadequacy is a low-value area, supporting the reallocation of economic resources for interventions of a higher value for patients.
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spelling pubmed-88704022022-02-25 Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study Maltoni, Roberta Balzi, William Rossi, Tania Fabbri, Francesco Bravaccini, Sara Montella, Maria Teresa Massa, Ilaria Bertoni, Lucia Falcini, Fabio Altini, Mattia Curr Oncol Communication The risk of relapse for early breast cancer (BC) patients persists even after decades and to date, no specific and sensitive effective circulating biomarker for recurrence prediction has been identified yet. The international guidelines do not recommend the assessment of the serum tumor markers CEA and CA15-3 in the follow-up of asymptomatic early BC patients. In our institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, as part of the E.Pic.A study, which was designed to assess the economic appropriateness of integrated care pathways in early BC, the use of CEA and CA15-3 as circulating tumor biomarkers in early BC patients was evaluated in 1502 patients one year after surgery, from 2015 to 2018, with an overall expense of EUR 51,764. A total of EUR 47,780 (92%) was used for execution of circulating tumor markers in early BC patients with stage 0, I and II tumors, neglecting the current guidelines and considered inappropriate by our professional board. We found that no patients with stage I BC experienced relapse in the 365 days after surgery, and in any case examination of the circulating markers CEA and CA15-3 was considered crucial for diagnosis of relapse. Our findings suggest that this inadequacy is a low-value area, supporting the reallocation of economic resources for interventions of a higher value for patients. MDPI 2022-01-18 /pmc/articles/PMC8870402/ /pubmed/35200539 http://dx.doi.org/10.3390/curroncol29020039 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Maltoni, Roberta
Balzi, William
Rossi, Tania
Fabbri, Francesco
Bravaccini, Sara
Montella, Maria Teresa
Massa, Ilaria
Bertoni, Lucia
Falcini, Fabio
Altini, Mattia
Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study
title Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study
title_full Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study
title_fullStr Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study
title_full_unstemmed Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study
title_short Appropriateness and Economic Analysis of Conventional Circulating Biomarkers Assessment in Early Breast Cancer: A Real-World Experience from the E.Pic.A Study
title_sort appropriateness and economic analysis of conventional circulating biomarkers assessment in early breast cancer: a real-world experience from the e.pic.a study
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870402/
https://www.ncbi.nlm.nih.gov/pubmed/35200539
http://dx.doi.org/10.3390/curroncol29020039
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