Genetic counseling program in familial breast cancer: analysis of its effectiveness, cost and cost-effectiveness ratio.

摘要: Women with a family history of breast cancer are at increased risk for developing this neoplasm. Starting surveillance more frequently younger age than the general population and possibility undergoing genetic testing options their medical management. We analyzed benefits costs our clinical program in familial (FBC) carried out cost-effectiveness analysis such procedure. The performing counseling screening FBC based on 143 high-risk families registered database between June 1995 December 2001 were analyzed. A decision tree was constructed to estimate survival benefit compared strategy not any protocol. estimated that prevalence BRCA mutation an unaffected relative cohort 10% 53% mutations found BRCA1 gene. assigned 58.5% lifetime 30-year-old carrier according SEER data. effectiveness obtained from experience data estimating derived other studies longer follow-up. used local payment calculate program. or BRCA2 genes identified 20% probands. Seventy primary cases recorded since onset Thirty percent tumors diagnosed through 71% them lymph node-negative 49% outside (p = 0.1). ratio 4,294 euros per life-year gained. model sensitive carriers, screening. In setting model, suggests may be cost-effective. These results need confirmed as effective interventions prevention being implemented. © 2004 Wiley-Liss, Inc.