Use of the 21-gene recurrence score assay (RS) can help to reduce health care spending and improve breast cancer treatment, but the extent of the benefit offered differs between younger women and those aged 75 years and older.
The RS is a number between 0 and 100 that estimates a patient’s likelihood of breast cancer recurrence by analyzing a panel of 21 genes within the tumor. The test can be somewhat expensive, at around $4,000, and is not always covered by insurance plans. However, knowing the likelihood of cancer recurrence can help physicians and patients better select monitoring and treatment regimens.
A new study showed that use of the RS assay in women younger than 55 years was associated with a 19.2% reduction in the use of chemotherapy. However, in women aged 75 years and older, the opposite outcome was observed: the older patient population saw an almost 6% increase in chemotherapy use. Furthermore, the medical costs for younger women who received the assay were $15,333 less than the adjusted 1-year medical costs for breast cancer patients of the same age who did not receive the test. Yet, in the older population, use of the assay was associated with a more than $3,000 increase in medical spending. The study was published in the Journal of Clinical Oncology.
The findings indicate that the use of the RS assay may be more beneficial for younger breast cancer patients. Although the report did not provide reasons for the differences between the outcomes of the two patient populations, the findings are consistent with other reports of higher costs associated with treating cancer in older adults. The National Cancer Institute reports that, in women aged 65 and older, the average cost associated with breast cancer can be more than $23,000 just for initial treatment, with additional costs for continued treatment.
