Introduction

Breast cancer is the most common form of cancer that affects nearly 1.7 million women around the world. The extent of the disease and its impact can be assessed from the fact that as many as 266,120 new cases of invasive breast cancer are estimated to be diagnosed in 2018 alone among women in the US.

Breast cancer, or for that matter, any other form of cancer, can severely affect the quality of life of an individual. Overall ts is observed that the breast cancer death rates are usually higher than other forms of cancer that are commonly reported, including lung cancer. This is especially true for women with breast cancer in the US. Thus, there is an immediate need to prevent cancer and have all the facilities to identify the malignancy in its early stage to that the survival rates are improved.

For many patients choosing to go abroad for treatment, the cost of cancer treatment is often the deciding factor. This is why it is important for them to know the actual cost range so that they can see whether it is feasible for them to afford it or not in a particular country.

Needless to say, no one prefers to save costs of health, especially when it is about cancer. However, the importance to know approximate costs of breast cancer treatment prior to travel cannot be underestimated.

The purpose of this Breast Cancer Cost Guide is to present information pertaining to the costs associated with the treatment of this malignancy. Additionally, it provides a detailed break up of the costs that a patient is expected to bear during their course of treatment and the factors that affect the total cost of treatment.

Breast Cancer Risk Factors

Every 1 in 8 women in the US is diagnosed with breast cancer. Even though the researchers have not been able to identify the exact reason or cause of breast cancer, it has been linked to a number of risk factors, including the following:

• The family history of breast cancer or any other cancer
• Inherited genetic mutations in BRCA1 and BRCA2 genes
• Spontaneous mutations in BRCA1 and BRCA2 genes
• The greater density of tissues in the breast
• Excessive weight
• Exposure to radiation before the age of 30
• Being a white woman
• Late pregnancy
• History or abortion
• No history of breastfeeding
• Lifestyle factors (Excessive drinking or smoking
• Limited physical activity and exercising
• Use of hormone replacement therapy (HRT)
• Early menstruation

These are some of the most common and known factors that increase the risk of breast cancer. However, there are several other factors that have emerged as a result of the recent research.

According to the researchers, the following are some of the emerging risks of breast cancer:

• Excessive exposure to light at night
• Low levels of vitamin D
• Unhealthy dietary choices
• Exposure to chemicals in food, cosmetics, plastics, fertilizers, and sunscreen
• Drinking polluted and chemical-containing water

Factors Affecting The Cost of Breast Cancer Treatment

The total breast cancer treatment cost depends on the overall policy of a country. Every country has different laws and taxes when it comes to medical treatment. Additionally, within a country, the exact cost may differ from one hospital to the other. It is common to notice a price difference of approximately 20 to 30 percent among different hospitals.

The following are some of the leading factors that affect the overall cost of breast cancer treatment:

The Fees of the Medical, Surgical, and Radiation Oncologist

Breast cancer treatment is extensive and requires the intervention of three types of cancer doctors – a medical, surgical, and radiation oncologist. Each of these specialists charges a different fee, depending on their overall experience, popularity, and the approach to treatment.

Type of Surgery

There are different types of breast cancer surgeries, the choice of which depends on the health of the patient and the stage and grade of cancer. For examples, the surgical oncologist may decide to conduct a breast conservative surgery or lumpectomy, partial mastectomy, or total mastectomy. The cost associated with each type of surgery is different. Sometimes, a patient does not require a surgery and only a few cycles of chemotherapy and radiation therapy are required. The overall treatment package cost for breast cancer is different for such patients.

The total cost of surgery also depends on whether the patient is getting a chemo port installed during the procedure. A chemo port is a pathway through which chemotherapy drugs can be directly given to the larger veins in the body. This device helps prevent complications associated with repeated IV administration of chemotherapy drugs.

Such veins that are injected with chemotherapy drugs may become stiff and eventually die over a period of time. A chemoport helps prevent such complications because the drugs are injected directly into the larger veins, which do not cause damage to the smaller veins.

Need For Cosmetic Surgery

A majority of women who undergo total mastectomy or complete breast removal often undergo a cosmetic procedure for breast reconstruction. Getting breast implants after breast cancer surgery instantly boosts their confidence by improving their overall appearance, shape, and size of the breasts. This procedure costs additional to the over breast cancer treatment cost.

Number of Chemotherapy and Radiation Therapy Cycles

In the case of some patients, the doctors feel that it is better to give a few cycles of chemotherapy to reduce the size of the cancer lump. This is done to improve the chances of surgical success and to ensure that a majority of the cancer cells are removed during the surgery. Such cycles of neoadjuvant chemotherapy cost additional to the cost of breast cancer surgery.

Additionally, the overall breast cancer treatment cost depends on the number of cycles of chemotherapy and radiation therapy that a patient has to undergo the surgery.

Hormone Receptor Status

The treatment cost also depends on the HER-2 receptor status of the patient. Patients who are HER-2 receptor positive are given an additional hormonal therapy after surgery. The cost of hormonal therapy depends on the brand and type of drugs used. It costs additional to the overall cost of breast cancer surgery.

Cost of Medications and Life-Long Care

Almost all breast cancer patients are required to follow a dose of medications even after their last cycles of radiation therapy. This is to reduce the chances of cancer recurrence.

In addition, there are patients who may require physical therapy after breast cancer surgery. This is especially true about a patient whose lymph nodes in the armpits are removed during the surgery. Removal of lymph nodes may pose a permanent damage to the affected arm. Therefore, it is necessary that the arm is kept in motion and active. Sometimes, an intervention of a physiotherapist is required to achieve the same.

Average Cost of Breast Cancer Treatment: Top Countries

The following table highlights the average cost of breast cancer treatment in some of the top medical tourism destinations in the world:

Procedure	India	Thailand	Singapore	UAE	Turkey	US
Breast cancer surgery (single mastectomy)	$3200	$2355	$20000	$7000	$3800	$15000
Chemotherapy	$2300 to $4000	$2160 to $3500	$7200 to $12000		$2000 to $4000	$13000 to $30000
Radiation Therapy	$3000 to $5000	$4000 to $6000	$20000 to $35000	$15000 to $25000	$6000 to $20000	$12000 to $30000

Breast Cancer Surgery Cost Itemized Breakdown

Pre-surgery Costs	Surgery Cost	Post-surgery Costs
Physical examination PET-CT Scan MRI Fine needle aspiration cytology (FNAC) Biopsy 2D-ECHO Blood workup Neoadjuvant chemotherapy (if required) Anticoagulants and antibiotics Painkillers	Surgery team fees Anesthesia charges OT charges Other consumables and medicines Blood transfusion, if needed ICU charges Biopsy excision cost	Medications for pain relief Other special consumables Medications Hospital bed charges Biopsy Physiotherapy (if needed) Any additional service availed Any other consultation Complications management Unanticipated care Follow-up cost Adjuvant chemotherapy (if required) Radiation therapy (if required)

Cost of Accommodation, Food, and Local Travel

Patients who travel from abroad to a particular country for treatment have to bear an additional cost of hotel accommodation, local traveling, and food. This additional cost on top of the treatment cost depends on individual preferences. For example, a patient may decide to stay in a 3-star, 4-star or a 5-star accommodation and prefer to eat exquisite cuisine during his or her stay. The cost increases with an increase in the level of luxury that a patient looks to have.

The following table highlights the approximate cost of accommodation and food in some of the most popular medical tourism destinations:

Cost (per night/day)	India	Thailand	Dubai	Hungary	Turkey	Singapore
Accommodation (3-star)	$30	$25	$70	$30	$20	$60
Accommodation 4-star)	$40	$36	$80	$45	$30	$90
Accommodation (5-star)	$75	$76	$115	$80	$44	$120
Meal for Two Individuals	$20	$26	$50	$35	$42	$90

Internationally Recognized JCI-certified Hospitals For Breast Cancer Treatment

Country	Hospital
India	Indraprastha Apollo Hospital (Delhi NCR)
	Artemis Hospital (Delhi NCR)
	SevenHills Hospital (Mumbai)
	Fortis Group of Hospitals (Pan India)
Turkey	Hisar Intercontinental Hospitals
	Medicana International
	Memorial Healthcare Group
Thailand	Vejthani Hospital
	Bangkok Hospital
UAE	Zulekha Hospital (Dubai)
	Aster DM Healthcare (Dubai
	Al Zahra Hospital (Sharjah)
	NMC Royal Hospital (Abu Dhabi)
Singapore	Gleneagles Hospital
	Parkway East Hospital
	Mount Elizabeth Hospital