Breast reconstruction rate and profile in a Singapore patient population: a National University Hospital experience

Sim, N.; Soh, Sharon; Ang, C. H.; Hing, Chor Hoong; Lee, Han Jing; Nallathamby, Vigneswaran; Yap, Yan Lin; Ong, Wei Chen; Lim, Thiam Chye; Lim, Jane Mingjie

doi:10.11622/smedj.2017035

Cited by 6 publications

(7 citation statements)

References 25 publications

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“…Our five-year trend shows a gradual increase in the rate of BR as in the case in Canada, USA, China, and Singapore (7)(8)(9). This finding may suggest a rise in the awareness of BR.…”

Section: Discussionsupporting

confidence: 58%

“…The overall trend is an increase in implantbased BR since most patients are opting for immediate breast reconstruction. We state that there is a progressive increase in immediate breast reconstructions over time compared to a predicted decline delayed BR in our tertiary center similar to other hospital-based studies (7)(8)(9)11). Further research into the determinants of timing of the BR needs to be explored, as our study design limited the ability to capture the influences of the trend at our hospital.…”

Section: Discussionsupporting

confidence: 58%

“…The same holds for tertiary care centers in the United States, whereby the rates of BR go up to 42% (4,7). In Asia, a similar study showed a rate of 24.3% while in China the rate remains stable at 3.5-4.5% over the past 15 years (8,9). Our study focused on a tertiary public hospital; a comparative study in a private hospital in Kenya has yet to be done.…”

Section: Discussionmentioning

confidence: 87%

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Predictors of post-mastectomy breast reconstruction in Kenya

Gichuru¹,

Kedera²,

Wanjeri³

et al. 2020

Ann Afr Surg.

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Background: Breast reconstruction following mastectomy has mental and physical health benefits. Several patient-centered factors predict the rate of breast reconstructions. We investigated the rates and predictors of breast reconstruction in postmastectomy patients diagnosed with breast cancer at a teaching and national referral center. Methods: A retrospective case-control study involving post-mastectomy females diagnosed with breast cancer from 2014 to 2018. Logistic regression evaluated potential predictors of breast reconstruction. Results: 312 women had mastectomies during the 5-year study period: 9 (2.88%) had breast reconstructionall breast reconstructions were autologous (latissimus flap). The rate of reconstruction increased over the study period, then dropped in 2018. Factors significantly affecting the rate of breast reconstruction included patient age and insurance coverage. Conclusion: In this hospital-based study, the rate of post-mastectomy breast reconstruction is low, despite the procedure being an essential component of breast cancer care. Age and insurance coverage are predictors for breast reconstruction.

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“…Our five-year trend shows a gradual increase in the rate of BR as in the case in Canada, USA, China, and Singapore (7)(8)(9). This finding may suggest a rise in the awareness of BR.…”

Section: Discussionsupporting

confidence: 58%

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 87%

See 1 more Smart Citation

Predictors of post-mastectomy breast reconstruction in Kenya

Gichuru¹,

Kedera²,

Wanjeri³

et al. 2020

Ann Afr Surg.

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“…The overall rate of breast reconstruction in the present study was 10.7%. Another survey [16] conducted in Singapore found that the breast reconstruction rate from 2001 to 2010 was 24.3%. Albornoz et al [17] reported immediate breast reconstruction trends in the U.S. using the Nationwide Inpatient Sample database from 1998 to 2008.…”

Section: Discussionmentioning

confidence: 99%

Current Status and Factors Influencing Surgical Options for Breast Cancer in China: A Nationwide Cross-Sectional Survey of 110 Hospitals

et al. 2020

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Background. There are limited nationwide data regarding breast cancer surgery in China. The Chinese Anti-Cancer Association's Committee of Breast Cancer Society and the Chinese Society of Breast Surgeons conducted a nationwide survey to examine the use of and barriers associated with surgical options among patients with breast cancer. Methods. Surveys were sent via e-mail to the directors of 110 centers that performed at least 200 breast cancer operations in 2017. The electronic questionnaire contained 183 questions and covered six aspects, including demographic information about the hospitals and surgeons, surgical practice, and application of breast reconstruction. Results. The selected hospitals were from 31 provinces or municipalities. The overall proportion of breast-conserving surgery (BCS) was 22%. Local gross domestic product was

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“…This variation could be accounted for by the large number of low-volume surgeons in the data base or that there are barriers to offering IBR even for some high-volume surgeons. The Scottish guidelines suggest a target of 10% [ 18 ] and Singapore 20% [ 19 ] despite the well documented safety and psychological and emotional well-being related benefits [ 14 , 15 ]. A Dutch retrospective analysis found key factors inhibiting the decision making of IBR post mastectomy [ 22 ] included higher age (62.2 vs 51.9) and BMI (27 vs 24.3) and failure of surgeon to offer IBR due to predicted need for post mastectomy radiation (29.3%) or just failure of informing the patient (10%).…”

Section: Discussionmentioning

confidence: 99%

What are the appropriate thresholds for High Quality Performance Indicators for breast surgery in Australia and New Zealand?

2020

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Aim To evaluate BreastSurgANZ members’ compliance at various threshold rates for 4 evaluable High-Quality Performance Indicators (HQPIs) introduced to improve patient care. To benchmark global best practice to assist in determining the eventual threshold standards. Method BreastSurgANZ Quality Audit data 2012–2016 & 2018 was used to determine rates of attainment through a range of thresholds for 4 HQPI’s. Rates were assessed for different volume surgeons and comparison made to international standards. Results 1.3761 patients needing mastectomy for in situ disease, if the threshold rate for immediate breast reconstruction (IBR) was ≥ 40% then 30% of all members and 78% of very high-volume surgeons achieved that rate, which is comparable to international recommendations. 2.26,007 patients requiring mastectomy, if the threshold rate for IBR was ≥ 20% then 28% of all surgeons and 78% very high-volume surgeons met the standard. This is below most international recommendations. 3. For 31,698 invasive tumours ≤ 2 cm, if the threshold rate for breast conservation was ≥ 70% then 64% of all surgeons met the standard; 70% is comparable internationally. 4.1382 women =<50 years if the threshold rate for neoadjuvant chemotherapy was set at ≥ 15% then 36% of surgeons complied; 15% is below most international recommendations. Conclusions Even at these modest thresholds there are low levels of achievement by BreastSurgANZ members with high volume surgeons more likely to comply. These thresholds are either comparable or lower than globally accepted standards. Members should strive to meet, even exceed these important goals as they are a metric of improved patient care.

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Breast reconstruction rate and profile in a Singapore patient population: a National University Hospital experience

Abstract: Introduction: Breast reconstruction is an integral part of breast cancer management, with the

Cited by 6 publications

References 25 publications

Predictors of post-mastectomy breast reconstruction in Kenya

Predictors of post-mastectomy breast reconstruction in Kenya

Current Status and Factors Influencing Surgical Options for Breast Cancer in China: A Nationwide Cross-Sectional Survey of 110 Hospitals

What are the appropriate thresholds for High Quality Performance Indicators for breast surgery in Australia and New Zealand?

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