PHC4 Issue Brief

PHC4 Issue Brief - Breast Cancer & Mastectomy Facts and Figures

November 3, 1997

The American Cancer Society projects that 180,200 new breast cancer cases will be diagnosed in the United States in 1997, and 43,900 women are expected to die from this disease. Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer, and it is the leading cause of cancer death among women 40 to 55 years of age.

According to these estimates, approximately 11,000 Pennsylvania women will find out this year that they have breast cancer.

Surgery is the primary treatment for breast cancer today, and, according to the American Cancer Society, approximately one-third of individuals who have a breast removed choose to have it rebuilt with their own tissue or with an implant. Surveys have shown that many women who have reconstructive surgery after mastectomy believe "the procedure helped counter some of the negative effects a mastectomy had on their sense of well-being and their feelings about their femininity."

According to the Pennsylvania Health Care Cost Containment Council's 1995 inpatient data, 7,244 women were admitted to Pennsylvania hospitals to undergo a mastectomy. (Additionally, the Council estimates that approximately 3,200 women had a surgical treatment for breast cancer in an outpatient setting. These women are not included in these figures.) Of the women who were hospitalized, approximately 70% (5,034) had either a simple or radical mastectomy, and approximately 30% (2,210) underwent a lumpectomy. The number of mastectomy cases "peaked" at about age 71.

Of those having either a simple or radical mastectomy, 10% had some form of reconstructive surgery during the same hospital admission. An additional 12% had reconstructive surgery during a subsequent hospital admission.

The average length of stay for patients who underwent reconstructive surgery during the same admission was 4.4 days. The average length of stay was 2.8 days for those who did not undergo reconstructive surgery. For lumpectomy patients, the average length of stay was 1.7 days.

The average charge for mastectomy with reconstructive surgery was $17,797 and $7,082 for mastectomy without reconstructive surgery. The average charge for lumpectomy was $7,758.

Mastectomy & Breast Reconstruction Figures for 1995:

	Number of Cases	Average Length of Stay	Average Charge
All mastectomy cases	7,244	2.5	$ 7,597
*Radical or simple mastectomy with* reconstruction**	504	4.4	$ 17,797
*Radical or simple mastectomy without* reconstruction**	4,530	2.8	$ 7,082
Lumpectomy	2,210	1.7	$ 7,758
Reconstruction during a subsequent hospital admission	612	2.7	$ 9,538

Notes:

These figures were generated from the Pennsylvania Health Care Cost Containment Council's inpatient data for calendar year 1995.
The average charges are median charges. These charges are associated with the entire hospitalization not just treatment associated with the mastectomy and/or reconstruction, and they are hospital charges only (they do not include physician fees, outpatient fees, etc.). Further, while charges are a standard way of reporting data, they do not reflect the actual cost of the treatment nor do they reflect the payment that the hospital may have actually received.

Cases were identified using ICD.9.CM codes (International Classification of Diseases, Ninth Revision, Clinical Modification). Definitions follow:

radical or simple mastectomy codes: 85.41 - 85.44, 85.45 - 85.48

lumpectomy codes: 85.20 - 85.25

reconstruction codes: 85.50 - 85.59, 85.7, 85.82 - 85.87, 85.93, 85.96

Only those mastectomy cases that also had a diagnosis of breast cancer were considered in the analysis. The ICD.9.CM diagnosis codes used to define breast cancer were: 174.0 - 174.9, 198.2, 198.81, 233.0, 238.3.
Male breast cancer cases were excluded.

ChartObject Figure 1: Mastectomy Procedures by Age Group - 1995

ChartObject Chart 1

ChartObject Figure 3: Percent Having Reconstruction for Women Having Simple or Radical Mastectomy

These Tables correspond to the Figures above.

Table 1: Number and Percentage of Cases

Mastectomy Procedures According to Age in Decades

		Cases
Age Group		Number	Percentage
Statewide		7,244	100%
	Less than 40 years	455	6%
	40 to 49 years	1,230	17%
	50 to 59 years	1,274	18%
	60 to 69 years	1,615	22%
	70 to 79 years	1,819	25%
	80 + years	851	12%

Table 2: Number and Percentage of Cases
Percent Having Reconstruction for Women Having Simple or Radical Mastectomy

	Age Group	Simple/Radical	Reconstruction Cases
		Number		Number	Percentage
Statewide - Simple/Radical		5,034		504	10.0%
	Less than 40 years	303		90	29.7%
	40 to 49 years	810		199	24.6%
	50 to 59 years	856		137	16.0%
	60 to 69 years	1,114		55	4.9%
	70 to 79 years	1,301		21	1.6%
	80 + years	650		2	0.3%

Table 3: Number and Percentage of Cases
Lumpectomy and Simple/Radical Mastectomy by Age Group

		Lumpectomy		Simple or Radical
	Age Group	Number	Percentage		Number	Percentage
Statewide		2,210	31%		5,034	69%
	Less than 40 years	152	33%		303	67%
	40 to 49 years	420	34%		810	66%
	50 to 59 years	418	33%		856	67%
	60 to 69 years	501	31%		1114	69%
	70 to 79 years	518	28%		1301	72%
	80 + years	201	24%		650	76%

Source: PHC4, 1995 Inpatient Database