An Analysis of Immediate Postmastectomy Breast Reconstruction Frequency Using the Surveillance, Epidemiology, and End Results Database
- 27 May 2011
- journal article
- Published by Hindawi Limited in The Breast Journal
- Vol. 17 (4), 352-358
- https://doi.org/10.1111/j.1524-4741.2011.01105.x
Abstract
Mastectomy is used to treat one third of the nearly 180,000 women diagnosed with breast cancer in the United States annually. In this study, we use population-level data from multiple years of the Surveillance, Epidemiology, End Results (SEER) database to further define patient, tumor, and geographic characteristics associated with immediate and early-delayed breast reconstruction. Population level de-identified data for the years 1998 to 2002 were extracted from the National Cancer Institute's (NCI) SEER cancer database. All female patients who were treated with mastectomy for a diagnosis of ductal and/or lobular breast cancer (including Paget disease) were included. The primary end point of interest was odds of reconstruction. Multivariate analysis was performed to control for patient demographic and oncologic characteristics. A total of 52,249 patients met the inclusion criteria. Reconstruction was performed in 8,446 patients (16.2%). Odds of reconstruction varied by region from 0.60 (Seattle) to 2.81 (Atlanta). African Americans were noted to have a significantly lower likelihood of reconstruction when compared with Caucasian patients (OR 0.60 versus 1.00). Patients living in nonmetropolitan regions were also significantly less likely to undergo reconstruction. Receipt of radiation therapy was also negatively correlated with likelihood of reconstruction. In this multicenter, multiyear analysis of factors associated with immediate or early-delayed reconstruction after mastectomy, we demonstrate that younger age, white race, metropolitan locale, and lower stage disease were all independently associated with higher likelihood of reconstruction. This information provides insight into breast reconstruction utilization and will help guide future studies to understand how these factors affect patient and physician decision-making.Keywords
This publication has 17 references indexed in Scilit:
- Recent trends and predictors in immediate breast reconstruction after mastectomy in the United StatesThe American Journal of Surgery, 2009
- Variation in Physician-patient Discussion of Breast ReconstructionJournal of General Internal Medicine, 2008
- Breast Reconstruction after Surgery for Breast CancerNew England Journal of Medicine, 2008
- Cancer Statistics, 2008CA: A Cancer Journal for Clinicians, 2008
- Short-Term and Long-Term Psychosocial Adjustment and Quality of Life in Women Undergoing Different Surgical Procedures for Breast CancerAnnals of Surgical Oncology, 2007
- Use of Breast Reconstruction After Mastectomy Following the Women's Health and Cancer Rights ActPublished by American Medical Association (AMA) ,2006
- Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: a prospective studyThe Breast, 2005
- The National Utilization of Immediate and Early Delayed Breast Reconstruction and the Effect of Sociodemographic FactorsPlastic and Reconstructive Surgery, 2003
- Cost Comparison of Mastectomy Versus Breast-Conserving Therapy for Early-Stage Breast CancerJNCI Journal of the National Cancer Institute, 2001
- EFFECTS OF IMMEDIATE BREAST RECONSTRUCTION ON PSYCHOSOCIAL MORBIDITY AFTER MASTECTOMYThe Lancet, 1983