Dutch breast reconstruction guideline

Mureau, Marc A.M.; Hulst, René R. W. J. van der; Woerdeman, Leonie A. E.; Leeuwenhoek, Antoni Van; Turnhout, Arjen A. W. M. Van; Posch, Nicole; Menke-Pluijmers, Marian B. E.; Luiten, Ernest J. T.; Westenberg, A. Helen; Gopie, Jessica P.; Zonderland, H M; Westerhof, M.; Krol-Warmerdam, E.M.M.; Niël‐Weise, Barbara S

doi:10.1016/j.bjps.2017.12.020

Cited by 23 publications

(16 citation statements)

References 7 publications

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“…The present study found an association between breast reconstruction and musculoskeletal problems (including arm symptoms), and between radiotherapy treatment and health problems in the breast (including skin problems). However, in the utilised database, only data about immediate breast reconstruction was available in the database used, whereas patients treated with radiotherapy may have received delayed breast reconstruction to avoid these effects [22]. Almost all health problems were reported consistently over the time since diagnosis (except for fatigue, hair loss and menopausal complaints), suggesting the majority of problems remained present over time.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported health problems and healthcare use after treatment for early-stage breast cancer

et al. 2019

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Background: A clear picture of treatment-related health problems following breast cancer treatment is useful in anticipating the informational and other needs of patients during follow-up. This study aimed to identify treatment-related health problems in breast cancer patients up to five years after diagnosis. Secondly, the use of care associated with these health problems was identified. Methods: 876 surgically-treated female patients diagnosed between 2012 and 2016 with early-stage breast cancer were asked to complete an online survey about their current health problems and use of care. Multivariate logistic regression analyses were applied to determine the effect of patient and treatment characteristics on health problems. Results: 404 patients responded (46%). The median age was 62.0 years (SD:10.9). Apart from breast surgery, patients had been treated with radiotherapy (72%), chemotherapy (49%), antihormonal therapy

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Section: Discussionmentioning

confidence: 99%

Patient-reported health problems and healthcare use after treatment for early-stage breast cancer

et al. 2019

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“…This large population‐based study, analysing patients from all hospitals treating breast cancer in the Netherlands, found that, compared with mastectomy alone, IBR after mastectomy reduced the likelihood of receiving adjuvant chemotherapy within 6 weeks of surgery, as recommended by Dutch and European guidelines, but not within 9 or 12 weeks. This suggests that postmastectomy IBR is not necessarily contraindicated in patients who need adjuvant chemotherapy, because in general IBR does not delay its initiation to a clinically relevant extent.…”

Section: Discussionmentioning

confidence: 99%

“…Adjuvant systemic treatment, including chemotherapy, reduces the risk of distant recurrence and breast cancer mortality. In the Netherlands, 6 weeks is the maximum time limit aimed for between surgery and initiation of adjuvant chemotherapy, as recommended by the European Society for Medical Oncology (ESMO) and the Netherlands Society for Plastic Surgery.…”

Section: Introductionmentioning

confidence: 99%

Nationwide population-based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy

Heeg

Harmeling

Becherer

et al. 2019

British Journal of Surgery

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Background: Initiation of adjuvant chemotherapy within 6-12 weeks after mastectomy is recommended by guidelines. The aim of this population-based study was to investigate whether immediate breast reconstruction (IBR) after mastectomy reduces the likelihood of timely initiation of adjuvant chemotherapy.Methods: All patients with breast cancer who had undergone mastectomy and adjuvant chemotherapy between 2012 and 2016 in the Netherlands were identified. Time from surgery to adjuvant chemotherapy was categorized as within 6 weeks or after more than 6 weeks, within 9 weeks or after more than 9 weeks, and within 12 weeks or after more than 12 weeks. The impact of IBR on the initiation of adjuvant chemotherapy for these three scenarios was estimated using propensity score matching to adjust for treatment by indication bias.Results: A total of 6300 patients had undergone primary mastectomy and adjuvant chemotherapy, of whom 1700 (27⋅0 per cent) had received IBR. Multivariable analysis revealed that IBR reduced the likelihood of receiving adjuvant chemotherapy within 6 weeks (odds ratio (OR) 0⋅76, 95 per cent c.i. 0⋅66 to 0⋅87) and 9 weeks (0⋅69, 0⋅54 to 0⋅87), but not within 12 weeks (OR 0⋅75, 0⋅48 to 1⋅17). Following propensity score matching, IBR only reduced the likelihood of receiving adjuvant chemotherapy within 6 weeks (OR 0⋅95, 0⋅90 to 0⋅99), but not within 9 weeks (OR 0⋅97, 0⋅95 to 1⋅00) or 12 weeks (OR 1⋅00, 0⋅99 to 1⋅01).Conclusion: Postmastectomy IBR marginally reduced the likelihood of receiving adjuvant chemotherapy within 6 weeks, but not within 9 or 12 weeks. Thus, IBR is not contraindicated in patients who need adjuvant chemotherapy after mastectomy.

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“…Breast reconstruction (BR) has long been recognized as a means of supporting recovery from the psychological and emotional trauma of mastectomy, enhancing body image and improving quality of life . Many guidelines globally now recommended BR for all women undergoing mastectomy as part of their breast cancer treatment …”

Section: Introductionmentioning

confidence: 99%

Patterns of immediate breast reconstruction in New South Wales, Australia: a population‐based study

Feng

Flitcroft

Leeuwen

et al. 2019

ANZ Journal of Surgery

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BackgroundThe rate of immediate breast reconstruction (IBR) following mastectomy for breast cancer in Australia is low and varies between regions. To date, no previous Australian studies have examined IBR rates between all hospitals within a particular jurisdiction, despite hospitals being an important known contributor to variation in IBR rates in other countries.MethodsWe used cross‐classified random‐effects logistic regression models to examine the inter‐hospital variation in IBR rates by using data on 7961 women who underwent therapeutic mastectomy procedures in New South Wales (NSW) between January 2012 and June 2015. We derived IBR rates by patient‐, residential neighbourhood‐ and hospital‐related factors and investigated the underlying drivers for the variation in IBR.ResultsWe estimated the mean IBR rate across all hospitals performing mastectomy to be 17.1% (95% Bayesian credible interval (CrI) 12.1–23.1%) and observed wide inter‐hospital variation in IBR (variance 4.337, CrI 2.634–6.889). Older women, those born in Asian countries (odds ratio (OR) 0.5, CrI 0.4–0.6), residing in neighbourhoods with lower socioeconomic status (OR 0.7, CrI 0.5–0.8 for the most disadvantaged), and who underwent surgery in public hospitals (OR 0.4, CrI 0.1–1.0) were significantly less likely to have IBR. Women residing in non‐metropolitan areas and attending non‐metropolitan hospitals were significantly less likely to undergo IBR than their metropolitan counterparts attending metropolitan hospitals.ConclusionWide inter‐hospital variation raises concerns about potential inequities in access to IBR services and unmet demand in certain areas of NSW. Explaining the underlying drivers for IBR variation is the first step in identifying policy solutions to redress the issue.

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Dutch breast reconstruction guideline

Cited by 23 publications

References 7 publications

Patient-reported health problems and healthcare use after treatment for early-stage breast cancer

Patient-reported health problems and healthcare use after treatment for early-stage breast cancer

Nationwide population-based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy

Patterns of immediate breast reconstruction in New South Wales, Australia: a population‐based study

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