Highlights
- •ER status is important in determining DCIS treatment.
- •Cost-savings with omission of routine PR testing for DCIS is $4.3 million.
- •PR testing should only be performed for ER negative DCIS.
Abstract
Background
In DCIS, ER status is an important marker. The utility of concomitant PR testing remains
unclear.
Methods
A single-institution retrospective cohort study was performed with a comparative analysis
of the NCDB to assess annual cost-savings with omission of routine PR testing. National
Medicare payment standards determined PR staining costs to be $124.92.
Results
150 institutional DCIS cases with receptor data were identified. 104 (69%) were ER+/PR+,
16 (11%) were ER+/PR-, and none were ER-/PR+. Omission of routine PR testing would
have resulted in $18,738 saved annually. Within the NCDB, 34,100 DCIS cases had receptor
data: 29,277 (85.9%) patients were ER+, and 26,008 (76%) were both ER/PR+. 211 (0.6%)
patients were ER-/PR+. Annual national cost-savings with omission of routine PR-testing
would have been $4.3 million.
Conclusion
PR testing for DCIS should be reserved only for patients with ER- DCIS undergoing
breast conservation to determine the utility of adjuvant endocrine therapy.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: October 18, 2022
Accepted:
September 29,
2022
Received in revised form:
September 8,
2022
Received:
June 22,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
