gms | German Medical Science

Background: Treatment of breast cancer patients requires an interdisciplinary approach starting with the primary diagnosis and leading to follow-up care. The best structure for effective treatment seems to focus the care in a certified breast center with an interdisciplinary cancer conference. However, financial disclosure and cost-benefit- and cost-income-relation between different fields acting together in the care of the individual patient remains unclear.

Methods: In the year 2004 a total of 1835 patients with the diagnosis of breast cancer were treated in the University Breast Center Franken (UBF). 363 patients were diagnosed with primary breast cancer. Using different financial calculation models costs of various diagnostic and therapeutic procedures, of the personal necessary, basic costs and between different disciplinies etc. were assessed.

Results/Conclusion: Applying the standards for the Deutsche Krebsgesellschaft (DKG) and the Deutsche Gesellschaft für Senologie (DGS) for certified breast centers the costs of an isolated breast center unlinked to a department are to high to achieve a positive financial result covering of the center’s costs. A breast center can only be part of a department especially if foccusing on the major cost factor labour. I.e. night care can be covered as a whole as it is in the department obstetrics and gynecology and therewith reduce costs. Furthermore, the out-patient treatment by specialists of the breast center must be honoured appropriately. The question whether the reimbursement of high quality breast cancer treatment is sufficient remains at present unsolved. However, it seems that a financial co-support by other sections of the department, by study patients and by inclusion of breast cancer patients with metastasis in the primary focus of the breast center is necessary to achieve a plus-minus result.