A pilot study evaluating the effects of Magtrace for sentinel biopsy regarding care process optimization, reimbursement, surgical time and patient comfort compared to standard Technetium
Shams S.1, Lippold K.2, Roehle R.3, Paepke S.4, Blohmer J.U.1, Karsten M.M.1
1Charité - Universitätsmedizin Berlin, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland, 2Charité - Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland, 3Charité - Universitätsmedizin zu Berlin, Institut für Biometrie und klinische Epidemiologie, Berlin, Deutschland, 4Technische Universität München, Klinik für Gynäkologie, München, Deutschland
Background: Sentinel lymph node removal after Technetium (Tc) localization is a mainstay of breast surgery. Timing of Tc injection, can complicate operating room schedules which can result in increased overall costs of care.
Methods: We compared 60 patients who underwent breast surgery including a sentinel node biopsy. Per surgeons choice 30 patients were treated with Tc and 30 patients with Magtrace.
Primary outcomes were time spent on the care pathway and operating time from incision to removal of the sentinel node. Secondary outcomes were patient pain levels and treatment cost.
Results: Mean time spent on the preoperative breast care pathway was 5.3 (SD=1.4) minutes in the Magtrace group and 81 (SD=19.9) minutes in the Tc group
(p= < 0.0001).
Median time from skin incision to sentinel extraction was 8.52 (IQR 3; 12) minutes in the Magtrace group and 10.93 (IQR 5.2; 13.5) minutes in the Tc group (p=0.277).
There were 9 preoperative days in the Magtrace group versus 12 in the Tc group.
Mean Length of stay (LoS) was 4.0 days in both groups and applying the InEK DRG-Benchmark 92% (Magtrace) vs. 94% (Tc-Group). DRG-Reimbursement remained unchanged as the method of sentinel lymph node localization did not cause changes in OPS coding. Overall treatment cost in the Magtrace group decreased by 360€ per case. However, additional cost for Magtrace must be included in the future.
Conclusion: Despite Magtrace localization being a new method, surgical time was similar and it could allow for time and cost savings once established.