EN
There is no single figure for breast cancer treatment cost in Germany: the bill follows a national tariff and an estimate for one specific case. That is the first thing a family needs to know when a diagnosis has rearranged its plans in a day and the question of money followed at once.
Below: which tariff catalogues apply, what examinations cost, what a Kostenvoranschlag (the hospital’s preliminary estimate) looks like, and who pays whom. This page covers money only; how breast cancer treatment in Germany itself is organised is described separately.
What moves the price up or down
Three things move the price: tumour stage and biology, the extent of surgery and drug therapy. The first is settled before admission: German pathologists almost always re-examine the slides and paraffin blocks sent in, confirming oestrogen and progesterone receptors, HER2 status and the Ki-67 index, which shows how fast cells divide. The whole plan rests on that report, so diagnosis is no formality before admission but a step that shifts the final sum.
Second, the extent of surgery. From histology and imaging the surgeon decides whether breast-conserving surgery is enough or a mastectomy with reconstruction is needed — different operations, different invoices. If a sentinel lymph node biopsy finds the first node draining the tumour free of cancer cells, the other armpit nodes stay and the hospital stay is shorter. So one diagnosis can produce sums differing several times over, depending on the operation, drug cycles, radiotherapy sessions and days on the ward.
Third, drugs and time. Monoclonal antibodies for a HER2-positive tumour, like immunotherapy for the triple-negative subtype, can cost more than the operation. One chemotherapy session’s price depends on the drug and regimen; chemotherapy cost in Germany has its own page. The plan is approved by a tumour board (Tumorboard), where surgeon, medical oncologist, radiation oncologist and pathologist sit together. At LMU University Hospital in Munich these boards meet in the breast centre of the Department of Obstetrics and Gynaecology, headed by Professor Sven Mahner.
The two catalogues: GOÄ and DRG
German hospitals bill from two national catalogues, the same for every department: outpatient services under the GOÄ, inpatient care under the DRG system. The GOÄ, the federal scale of physicians’ fees, gives each service a base rate and a multiplier, usually from 1.0 to 3.5. Going above 2.3 is allowed only for unusual difficulty or time (§ 5 GOÄ) and must be justified in writing on the invoice (§ 12 GOÄ).
Inpatient care is priced by DRG: the case is assigned to a group by diagnosis, comorbidities and the extent of surgery, and the group carries a sum known in advance.
The tariff does not depend on citizenship: a local resident and a patient from abroad are billed from the same catalogue, and the law requires general hospital services to be charged uniformly to all patients. Both catalogues are public; the official text of the GOÄ lists every service with its number and rate. The hospital must state each service’s code on the invoice, so any line can be looked up. General cancer treatment prices in Germany are on a separate page.
What the examination costs
Examinations cost from 130 € for a first consultation to 900–1000 € for a contrast-enhanced MRI; they are priced separately, and the estimate starts with them. If the family first wants only a German oncologist’s view of the existing records, without travelling, that is a separate service — a second opinion from a German doctor: the pathologist re-reads slides and blocks, the oncologist reviews images and reports, the hospital sets the price in its estimate, and the result is a written report for deciding whether to travel. Prices on site:
- Breast and regional lymph node ultrasound: 130–150 €;
- Magnetic resonance imaging (MRI) with contrast: 900–1000 €;
- Computed tomography (CT) with contrast: approx. 550 €;
- Initial consultation with an oncologist or gynaecologist: from 130 €;
- Comprehensive gynaecological check-up (1 day): approx. 1500 €.
These figures cover examinations, not a programme: surgery with histology and days on the ward, chemotherapy cycles and breast cancer radiotherapy are counted separately and vary far more, so figures for a specific case come only from the hospital’s estimate. Costs can still be calculated in advance because protocols are standardised: breast cancer remains the most common tumour in women worldwide, and according to WHO data it was diagnosed in 2.4 million women in 2024.
What is in the estimate and who invoices whom
The estimate lists every medical service at tariff, and the patient pays the hospital directly. The hospital combines the GOÄ and DRG parts into one document, the Kostenvoranschlag (preliminary estimate), and sends it before the trip. The deposit goes to the hospital’s account named in it, never to an intermediary, so ask any agency who receives the money and under which document. Typical lines:
| Cost item | What it depends on | Guide figure |
|---|---|---|
| Consultations and examinations | What must be repeated | From 130 € (see the list above) |
| Second reading of histology | Whether slides and blocks need re-examining | Hospital’s estimate |
| Surgery and days on the ward | Extent of surgery, comorbidities (they set the DRG group), days on the ward | Hospital’s estimate |
| Drug therapy | Drug, regimen, number of cycles | Hospital’s estimate |
| Radiotherapy | Number of sessions | Hospital’s estimate |
| Treatment by the head of department, single room | The patient’s choice; agreed in writing before treatment | Hospital’s estimate |
After discharge the hospital recalculates what was delivered: an unspent part of the deposit is refunded to the same account, an overrun is billed on an itemised additional invoice. Any line can be explained by its service code; if one is unclear, ask: “What is this service, and under which catalogue number was it charged?”
Outside the medical invoice sit a relative’s accommodation, transport, translations beyond the programme and a visa extension if treatment runs longer. They are agreed in advance, so no surprise lines appear at the end.
The stay depends on the plan: surgery means days on the ward, radiotherapy weeks of weekday sessions, drug therapy cycles with breaks, and the family decides in advance whether to stay in Germany in between. Accommodation and flights follow from that. After discharge come follow-up visits and, for a hormone-sensitive tumour, years of hormone therapy; these are outside the surgery estimate, so where follow-up happens, at home or in Germany, is agreed beforehand.
Frequently asked questions
How much does it cost to treat breast cancer in Germany?
There is no single sum: the bill combines examinations, surgery, drug therapy and radiotherapy, each priced by the national tariff. Firm figures exist only for examinations: a first consultation from 130 €, a one-day check-up about 1500 €. The hospital prices treatment in its estimate after reviewing the records.
How much does the operation cost?
Only the hospital’s estimate gives the sum: the stay is priced by its DRG group, which depends on the extent of surgery and on comorbidities. Breast-conserving surgery and mastectomy with reconstruction fall into different groups. Treatment by the head of department and a single room, if chosen, are separate lines.
Whom do we pay, and how?
Pay the hospital directly: the deposit goes to the account in its official estimate, the Kostenvoranschlag, not to an intermediary. After discharge the hospital recalculates and refunds the balance or issues an itemised additional invoice. If an intermediary wants the medical payment on its own account, ask under which document.
How AlenMed arranges treatment and requests the estimate
AlenMed collects and translates the records and passes them to oncologists; the doctor outlines the approach and asks the hospital for an official estimate. Needed are discharge summaries, the histology report, sometimes the paraffin blocks for re-reading, and DICOM imaging — mammography, ultrasound, MRI, CT. The answer usually takes two to five working days, and the official invitation letter for the visa comes with the estimate.
AlenMed has 86 partner hospitals in 38 cities and 345 doctors; the company office is in Munich. For breast cancer we work with certified breast centres (Brustzentrum) and university hospitals across Germany; breast cancer hospitals in Germany are listed separately. A coordinator meets the patient, interprets at appointments and collects the discharge summary, pathology report and follow-up plan for the oncologist at home.
For reference only; not a public offer. The final cost is set by the hospital in its official estimate (Kostenvoranschlag) after reviewing the medical records, and the treatment plan by a doctor at an in-person consultation.