The Cost of Breast Cancer: Economic and Social Perspective

Background: Breast cancer imposes a substantial global health and economic burden, with costs varying across disease stages, treatment modalities, and healthcare systems. Understanding these costs is crucial for informing policy and guiding efficient allocation of healthcare resources. Objectives: This systematic review aimed to summarize available evidence on the economic burden of breast cancer, including direct and indirect costs, and to evaluate the cost-effectiveness of treatment strategies reported in recent studies. Methods. Following PRISMA 2020 guidelines, a systematic search was conducted in MEDLINE and Academic Search Ultimate (January 2024–May 2025). Studies were included if they evaluated costs or cost-effectiveness in breast cancer patients. Screening and data extraction were performed independently by two reviewers. Data were synthesized narratively and summarized in evidence tables. Results: Twenty-seven studies were included. Reported costs varied widely by country, stage, and healthcare setting. In Dubai, inpatient costs reached USD 16,956 and medications USD 10,251, accounting for 84% of the disease burden. In Canada, annual excess costs per case averaged USD 27,485, with expenditures highest during the first year after diagnosis. Cost-effectiveness analyses indicated variable outcomes: toripalimab plus chemotherapy yielded an ICER of USD 16,133/QALY, suggesting potential cost-effectiveness, whereas some regimens, such as for metastatic triple-negative breast cancer, exceeded USD 500,000/QALY and were not cost-effective. Indirect costs, including productivity loss, were less frequently studied but contributed significantly to the overall burden. Conclusions: Breast cancer generates considerable direct and indirect costs, with marked heterogeneity across settings and stages. Standardized economic evaluations and broader inclusion of indirect costs are needed to better inform policy and resource planning.