极端肿瘤整形保乳手术 (eOBCS) 描述了 OBCS 在原本需要乳房切除术的患者中的应用，其安全性之前已经描述过。我们的目的是比较 eOBCS 和乳房切除术的费用。我们审查了我们的机构数据库以识别乳房切除术2018 年至 2023 年接受手术治疗的癌症患者。我们纳入了疾病跨度较大（≥5 cm）和多灶性/多中心疾病的患者。患者根据手术方法（即 eOBCS 或乳房切除术）进行分组。确定并比较直接护理费用； 86 名患者符合纳入标准，其中 10 名（11.6%）接受了乳房切除术，76 名（88.4%）接受了 eOBCS。 6 名乳房切除患者 (60%) 接受了乳房重建，6 名 (60%) 接受了外照射放射治疗 (EBRT)。重建工作是分阶段完成的，索引手术（乳房切除术和组织扩张器）的平均成本为 17,816 美元。这些患者随后接受了一到三次手术来完成重建，平均费用为 45,904 美元。 EBRT 的平均费用为 5542 美元。 34 名 eOBCS 患者 (44.7%) 接受了 44 次边缘再切除，其中 6 名 (7.9%) 接受了乳房切除术。 60 名 (78.9%) 的 eOBCS 患者接受了 EBRT。他们的指数操作平均成本为 6345 美元；再次切除的平均费用为 3615 美元；乳房切除重建的平均费用为 49,400 美元； EBRT 的平均费用为 6807 美元。 eOBCS 患者的护理费用仍然低于乳房切除术患者的护理费用，即 17,318 美元和 57,416 美元。乳房切除术的费用低于 eOBCS，而 eOBCS 的转换率比乳房切除术低。© 2024。外科肿瘤学会。

Extreme oncoplastic breast-conserving surgery (eOBCS) describes the application of OBCS to patients who would otherwise need a mastectomy, and its safety has been previously described.We aimed to compare the costs of eOBCS and mastectomy.We reviewed our institutional database to identify breast cancer patients treated surgically from 2018 to 2023. We included patients with a large disease span (≥5 cm) and multifocal/multicentric disease. Patients were grouped by their surgical approach, i.e. eOBCS or mastectomy. The direct costs of care were determined and compared; however, indirect costs were not included.Eighty-six patients met the inclusion criteria, 10 (11.6%) of whom underwent mastectomy and 76 (88.4%) who underwent eOBCS. Six mastectomy patients (60%) had reconstruction and 6 (60%) underwent external beam radiation therapy (EBRT). Reconstructions were completed in a staged fashion, and the mean cost of the index operation (mastectomy and tissue expander) was $17,816. These patients had one to three subsequent surgeries to complete their reconstruction, at a mean cost of $45,904. The mean cost of EBRT was $5542. Thirty-four eOBCS patients (44.7%) underwent 44 margin re-excisions, including 6 (7.9%) who underwent mastectomy. Sixty (78.9%) of the eOBCS patients had EBRT. The mean cost of their index operation was $6345; the mean cost of a re-excision was $3615; the mean cost of their mastectomies with reconstruction was $49,400; and the mean cost of EBRT was $6807. The cost of care for eOBCS patients remained lower than that for mastectomy patients, i.e. $17,318 versus $57,416.Mastectomy is associated with a lower cost than eOBCS, which had a low conversion rate compared with mastectomy.© 2024. Society of Surgical Oncology.