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

J Surg Oncol. 2017 Nov;116(6):683-689. doi: 10.1002/jso.24712. Epub 2017 Jun 12.


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.

Keywords: breast conserving surgery; breast neoplasms; health services accessibility; radiotherapy adjuvant; radiotherapy intraoperative.

MeSH terms

  • Breast Neoplasms / economics*
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Breast Neoplasms / therapy*
  • Combined Modality Therapy
  • Developing Countries
  • Female
  • Health Care Costs
  • Health Services Accessibility / economics*
  • Humans
  • Intraoperative Care / economics
  • Intraoperative Care / methods
  • Mexico
  • Middle Aged
  • Radiotherapy / economics
  • Radiotherapy / methods
  • Time Factors
  • Travel / economics*