‘Unnecessary’ tests on early-stage breast cancer patients costly to economy

Needless tests could mean annual loss of NIS 4 million to economy, says senior Sourasky oncologist.

By JUDY SIEGEL-ITZKOVICH
Updated: JANUARY 17, 2016 03:41
Breast cancer (illustrative photo) (photo credit: INGIMAGE)
Breast cancer (illustrative photo)
(photo credit: INGIMAGE)
Two out of five women who have been diagnosed at Tel Aviv Sourasky Medical Center with early stage breast cancer were sent for unnecessary medical tests, according to Prof. Moshe Inbar, head of the medical center’s oncology department.
Inbar said that these tests resulted in a loss of much money to the health system, as well as unnecessary pressure and anxiety for the patients. The study results were publicized at an oncology conference on Thursday.
Dr. Larissa Ribo, a senior doctor in Sourasky’s oncology institute, conducted a survey and identified the needless tests undergone by many patients. Every year, some 4,500 women here are diagnosed with breast cancer, and about a half are told at a very early stage, when the chances for recovery are close to 1,000 percent and the risks of metastasis at the time of diagnosis are near zero.
Leading international oncology societies, she said, urge not carrying out CD, MRI or PET/ CT scans of such patients, as it is “unnecessary and very costly to the economy and in some cases can cause significant damage to the patients.”
Surveys in the US and Britain found that the rate of needless tests can reach as much as 80% of breast cancer patients, said Ribo. To determine whether there was a similar situation in Israel, she studied medical files of 825 patients treated at the oncology department of Sourasky’s Ichilov Hospital in 2014. A total of 179 of them were diagnosed at a very early stage and thus met the criteria for not undergoing extensive tests.
Among the tests ruled “unnecessary” were 39 special blood tests and imaging scans that cost a total of NIS 250,000, Ribo said. Forty percent of the patients were referred for the tests by their family physicians, surgeons and oncologists.
Inbar said that if the situation at Ichilov is representative of the whole country, “the result is the waste of NIS 4 million a year, excess use and crowding at imaging institutes and damage to many patients.
“It must be made clear that there is no early diagnosis of metastases, and all efforts to find them can harm the woman’s way of life and lead to needless treatments that they don’t need.”
With help from the National Center for Health Services’ Research, “we intend to expand the survey to additional hospitals and to ask doctors who treat breast cancer the possible reasons for the phenomenon.
Is it caused by a lack of knowledge among doctors, preferring persona experience to following international guidelines or patients’ pressure on doctors?” Inbar asked.