Table 2 Summary of characteristics for included studies
Study, country | Target population | Type of model | Perspective, type of study | Intervention and Comparator | Results |
|---|---|---|---|---|---|
Surgery plus adjuvant treatments used for comparisons | |||||
 Naeim et al. (2005) [18] USA | Subgroup analyses: 45,65, 75, 85 years women with early-stage node (+) breast cancer | Not stated | Health care provider CUA and CEA | Adjuvant chemo alone (CMF) Adjuvant chemo alone (AC) Adjuvant endocrine alone (Tamoxifen) Adjuvant Chemo (CMF) + Tamoxifen Adjuvant Chemo (AC) + Tamoxifen | Adjuvant endocrine treatment was cost-effective in older women |
 Naeim et al. (2005) [19] USA | Subgroup analyses: 45,65, 75, 85 years women with early-stage node (+) breast cancer | Not stated | Health care provider CUA and CEA | Adjuvant chemo alone (CMF) Adjuvant chemo alone (AC) Adjuvant endocrine alone (Tamoxifen) Adjuvant Chemo (CMF) + Tamoxifen Adjuvant Chemo (AC) + Tamoxifen | Adjuvant endocrine treatment was cost-effective in older women |
 Ward et al. (2019) [23] USA | Older women targeted: 70 years or older with estrogen-positive invasive breast cancer | Patient-level Markov microsimulation | Societal CUA and CEA | Adjuvant radiotherapy (APBI- alone) Adjuvant endocrine (Aromatase inhibitor alone) | Adjuvant endocrine treatment alone was the cost-effective strategy |
 Ward et al. (2020) [22] USA | Older women targeted: 70 years or older with estrogen-positive invasive breast cancer | Patient-level Markov microsimulation | Societal CUA and CEA | Adjuvant endocrine (Aromatase inhibitor alone) Adjuvant radiotherapy (APBI-alone) Their combination | Adjuvant endocrine treatment alone was the cost-effective strategy |
Surgery as the comparator strategy | |||||
 Desch et al. (1993) [24] USA | Subgroup analyses: 60 to 80 years women with a diagnosis of primary breast cancer | Markov model | Societal CUA and CEA | Surgery alone Adjuvant chemotherapy alone | Adjuvant chemo was not a cost-effective treatment strategy for women aged more than 75 years |
 Skedgel et al (2013) [21] Canada | Subgroup analyses: 40, 50, 60, 70 and 80 + years women with T1bN0 breast cancer | Markov model | Direct payer CUA and CEA | Surgery alone Adjuvant chemotherapy alone Adjuvant chemotherapy + concurrent trastuzumab Adjuvant chemotherapy + sequential trastuzumab | Concurrent trastuzumab plus adjuvant chemotherapy was a cost-effective strategy |
 Sen et al. (2014) [20] USA | Older women targeted: 70, 75, and 80 years women with early-stage breast cancer | Markov model | Payer CUA and CEA | Surgery alone Adjuvant Radiotherapy EBRT Adjuvant Radiotherapy IMRT | EBRT was the cost-effective strategy |