With Health Insurance: Copays + 10%-50% Coinsurance
Without Health Insurance: $15,000-$50,000+
Breast cancer treatment usually involves surgery -- a lumpectomy or mastectomy -- sometimes followed by chemotherapy, radiation or other treatments.
Typical costs:
For patients covered by health insurance, out-of-pocket costs for breast cancer treatment typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can easily reach the yearly out-of-pocket maximum. Breast cancer treatment typically is covered by health insurance, although some plans might not cover individual drugs or treatments.
For patients not covered by health insurance, breast cancer treatment typically costs $15,000-$50,000 or more for a mastectomy or $17,000 to $35,000 or more for a lumpectomy followed by radiation.
Chemotherapy can cost about $10,000-$100,000 or more, depending on the drugs, the method of administration and the length or number of treatments. For example, women on a BreastCancer.org forum[1] report chemotherapy costs of $7,000-$40,000 per treatment.
Depending on the individual case and the type and number of treatments needed, the total cost of breast cancer treatment, on average, can reach $100,000 -- or, in advanced cases, $300,000 or more. In a BreastCancer.org forum[2] , patients discuss total costs of their breast cancer treatment. For example, a study[3] published in BMC Cancer found that the average total cost of care over a mean follow-up of 532 days was about $128,500 for women with metastatic breast cancer receiving chemotherapy as their primary treatment. This includes the cost of the chemotherapy drugs, additional drugs to help manage side effects, administration of the drugs and medical care for chemotherapy-related complications.
The American Society of Clinical Oncology has a guide to managing the costs of cancer care[4] .
Most breast cancer patients undergo surgery[5] -- either a lumpectomy[6] , a partial mastectomy[7] , a simple mastectomy[8] or a modified radical mastectomy[9] . (A radical mastectomy[10] usually is not performed because a modified radical mastectomy removes less tissue and is about as effective.) The type of surgery performed typically depends on the size and stage of the cancer and other factors.
Some breast cancer patients undergo radiation therapy[11] , either after surgery to reduce the chance of recurrence, as an alternative treatment if surgery cannot be performed, or if the cancer has spread.
Some patients undergo oral or IV chemotherapy[12] , before surgery to help shrink the tumor, after surgery, or if surgery cannot be performed.
Patients whose breast cancer cells have estrogen or progesterone receptors may undergo hormone therapy[13] , to inhibit the cancer cells' growth.
The National Cancer Institute offers an overview[14] of breast cancer treatments.
Additional costs:
If a mastectomy is required, the patient might choose to get breast reconstruction. This typically costs $5,000-$15,000 or more per breast for implants or from $25,000-$50,000 or more per breast for "flap" techniques using tissue from the patient's own body.
Breast cancer patients will need regular follow-up doctor visits and screenings to check for recurrence. The American Society of Clinical Oncology offers guidelines for follow-up care that include doctor visits every three to six months for the first three years, and a mammogram, which costs about $100, every six to 12 months.
Discounts:
Many hospitals give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System[15] in California offers a 35% discount.
Some state or regional programs offer free treatment. For example, the Commonwealth of Pennsylvania Breast and Cervical Cancer Prevention and Treatment Program offers free treatment[16] to uninsured or underinsured women living in Pennsylvania who meet income guidelines. And the Illinois Breast and Cervical Cancer Program offers free treatment[17] to uninsured women aged 35-64 (or, in some cases, younger) who live in Illinois.
The United Breast Cancer Foundation offers grants[18] to help pay for treatment for qualifying patients, typically those with income below two and a half times the federal poverty level.
Shopping for breast cancer treatment:
The American Society of Clinical Oncology offers an oncologist locator[19] by state with the option to search for a breast cancer specialist. And the National Cancer Institute has a search tool[20] for NCI-designated cancer centers.
WebMD offers a guide to the types of breast cancer specialists[21] , and the National Cancer Institute offers a guide to finding a doctor or cancer treatment facility[22] .
WebMD offers a primer[23] on getting a second opinion for breast cancer diagnosis and treatment.
Breastcancer.org offers information on clinical trials[24] .
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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Type of Treatment: Lumpectomy, Chemo, Radiation, Hormone
Provider: Texas Oncology
Wife had a 12mm lump in breast (1.2cm). It was removed via lumpectomy with clear margins. Doc determined that it was Stage 1 (no lymph node intrusion) HER2+ (triple positive) breast cancer. Doc recommended 13 weeks of Herceptin ($13,000/week) and Taxol ($4000/week) concurrently, followed by 5 weeks of daily radiation. She's currently on 10 years of oral Tamoxifen. Basically the doc threw the book at her. It was rough but we're glad that she got such thorough treatment. Overall cost of treatment approximately $350,000. Our insurance had a 5k/year deductible. Tx Oncology either waived most of it or volunteered to write off a big part of it. Total out of pocket probably around 12-15K. I will never complain about health insurance premiums again.
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