Recent trends and predictors in immediate breast reconstruction after mastectomy in the United States

• Published in: The American journal of surgery Vol. 198; no. 2; pp. 237 - 243
• Main Authors: Reuben, Brian C., M.D, Manwaring, Jotham, M.D, Neumayer, Leigh A., M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2009; Elsevier; Elsevier Limited
• Subjects: Adult; Age Factors; Aged; Biological and medical sciences; Breast; Breast cancer; Breast reconstruction; Classification; Comorbidity; Data processing; Databases, Factual; European Continental Ancestry Group; Female; General aspects; Geography; Gynecology. Andrology. Obstetrics; Hospitals, Teaching; Humans; Identification methods; Immediate reconstruction; Insurance, Health; International Classification of Diseases; Mammaplasty - statistics & numerical data; Mammary gland diseases; Mastectomy; Mastectomy - statistics & numerical data; Medical sciences; Middle Aged; Multivariate Analysis; Patients; Plastic surgery; Regression analysis; Residence Characteristics; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Time Factors; Tumors; United States; Urban areas; Urban Health Services; Womens health; United States; North America; America; United States > US; Mastectomy; Breast cancer; Immediate reconstruction; Breast reconstruction; Breast disease; Prediction; Trend; Anatomical reconstruction; Malignant tumor; Medicine; Plasty; Mammary gland diseases; Treatment; Surgery; Breast; Mammary gland; Predictive factor; Cancer
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2008.11.034

Abstract Introduction Immediate breast reconstruction after mastectomy has increased in frequency during the past decade, but the socioeconomic and patient factors have yet to be fully identified. Methods Data were analyzed from the Nationwide Inpatient Sample from 1999 to 2003 using International Classification of Disease–9 codes to identify patients undergoing immediate breast reconstruction. Regression analyses were used to examine predictive variables for immediate breast reconstruction after mastectomy. Results Between 1999 and 2003, 469,832 patients underwent mastectomy. Immediate breast reconstruction occurred in 110,878 patients, yielding a 5-year average rate of 23.6% (range of 22.2% to 25.3%). Independent predictors of immediate breast reconstruction after mastectomy include private insurance, hospital in an urban location, teaching hospital, white race, hospital region in the south, age between the 3rd and 6th decades, and low number of comorbidities. Conclusions Immediate breast reconstruction after mastectomy is still not commonly performed in the United States. Socioeconomic and geographic factors play a significant role in whether patients undergo immediate reconstruction.