The impact of the use of intraoperative radiotherapy on costs, travel time and distance for women with breast cancer in the Mexico City Metropolitan Area

• Published in: Journal of surgical oncology Vol. 116; no. 6; pp. 683 - 689
• Main Authors: Bargallo‐Rocha, Juan Enrique, Soto‐Perez‐de‐Celis, Enrique, Picó‐Guzmán, Francisco Javier, Quintero‐Rodríguez, Carlos Eduardo, Almog, David, Santiago‐Concha, Gabriel, Flores‐Balcazar, Christian Haydee, Corona, Jaime, Vazquez‐Romo, Rafael, Villarreal‐Garza, Cynthia, Mohar, Alejandro
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-11-2017
• Subjects: Breast cancer; breast conserving surgery; breast neoplasms; Breast Neoplasms - economics; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; Breast Neoplasms - therapy; Cancer surgery; Combined Modality Therapy; Costs; Developing Countries; Female; Health Care Costs; health services accessibility; Health Services Accessibility - economics; Humans; Intraoperative Care - economics; Intraoperative Care - methods; LDCs; Mexico; Middle Aged; Radiation therapy; Radiotherapy - economics; Radiotherapy - methods; radiotherapy adjuvant; radiotherapy intraoperative; Time Factors; Travel - economics; Mexico; radiotherapy intraoperative; breast conserving surgery; health services accessibility; radiotherapy adjuvant; breast neoplasms
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.24712

Background and Objectives
The low availability and poor access to external beam radiotherapy (EBRT) in developing countries makes it hard for women with breast cancer to receive breast conservation. We studied the effect of providing intraoperative radiotherapy (IORT) on the travel time, distance, and costs of in the Mexico City Metropolitan Area (MCMA).
Methods
Sixty‐nine patients treated between January 2013 and September 2014 were analyzed. Travel distance and transit time was calculated using Google Maps. The time and distance patients living in the MCMA treated with IORT would have spent if they had received EBRT was calculated. Cost analysis for each modality was performed.
Results
71% (n = 49) lived in the MCMA. Sixteen (33%) received additional EBRT and 33 (66%) received IORT only. Mean driving distance and transit time of those 33 women was 132.6 km (SD 25.7) and 66 min (SD 32.9). Patients from the MCMA receiving IORT alone avoided 990 visits, 43 700 km and 65 400 min in transit. IORT led to a 12% reduction in costs per patient.
Conclusions
By reducing costs and time needed for patients to receive radiotherapy, IORT could potentially enhance access to breast conservation in resource‐limited developing countries.