Patients opting for breast reconstruction following mastectomy: an analysis of uptake rates and benefit

Howard-McNatt, Marissa

doi:10.2147/bctt.s29142

Cited by 30 publications

(44 citation statements)

References 77 publications

(88 reference statements)

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“…This compares favourably with rates of 16–59 per cent internationally3 8, 19 27, 28, 29, 30. The strongest predictors of PMBR cited were: age under 50 years; white race; higher income and education; and earlier disease stage31. This is reflected in the present cohort where younger age and earlier disease stage were predictive of PMBR.…”

Section: Discussionsupporting

confidence: 59%

“…There are several factors influencing the rising rates of breast reconstruction internationally. The introduction of the Women's Health and Cancer Rights Act of 1998, requiring health insurance policies in the USA to reimburse breast reconstruction procedures after mastectomy, has been paramount to the recent higher reconstruction rates in America31. In the present study, there was a peak in numbers of women undergoing PMBR in 2008 ( Fig .…”

Section: Discussionmentioning

confidence: 55%

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Trends in breast reconstruction practices in a specialized breast tertiary referral centre

et al. 2017

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BackgroundBreast reconstruction is an important component of multidisciplinary breast cancer management. The practice of breast reconstruction after mastectomy has evolved significantly in the past decade as a result of both increasing mastectomy rates and advances in reconstructive strategy. These changes have significantly influenced the contemporary surgical management of breast cancer. The aim of this study was to examine trends in breast reconstruction after mastectomy in an Irish population.MethodsData were reviewed from a database of all patients who had mastectomy with or without breast reconstruction at Galway University Hospital, a tertiary breast cancer referral centre, between 2004 and 2014. Trends in breast reconstruction after mastectomy were explored with respect to patient demographics, clinicopathological features, and neoadjuvant and adjuvant therapy.ResultsOf 1303 patients who underwent mastectomy during interval studied, 706 (54.2 per cent) had breast reconstruction after mastectomy. In 629 patients (89·1 per cent), breast reconstruction was performed in the immediate setting. Reconstruction rates increased over time from 20·5 per cent in 2004 to 44·7 per cent in 2014. Reconstruction was more commonly performed in younger patients and those with benign, in situ and early‐stage disease. A negative relationship between radiotherapy and reconstruction was observed. A pedicled flap with or without an implant was the most commonly used reconstructive approach in patients receiving radiotherapy.ConclusionBreast reconstruction after mastectomy has become the standard of care in the surgical treatment of breast cancer. Recent trends show a transition favouring implant‐based approaches.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 55%

Trends in breast reconstruction practices in a specialized breast tertiary referral centre

et al. 2017

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“…We recognize that several complex factors are associated with uptake of breast reconstruction following mastectomy (age, ethnicity, income, education, tumor characteristics, health-related issues, surgeon/hospital factors, and psychological or other factors) 4,11–16. We are also aware that other factors may have contributed to this increased rate of uptake, including an increased trend in breast reconstruction nationally9 and possible local logistical aspects (improved process in booking surgery, theater availability, and streamlined referral to plastic team); however, we believe that the introduction of the OP MDT was the key factor in this process and the comparative data in this study (Table 1) supports this assumption.…”

Section: Discussionmentioning

confidence: 99%

Improved immediate breast reconstruction as a result of oncoplastic multidisciplinary meeting

El-Gammal¹,

Lim²,

Uppal³

et al. 2017

BCTT

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IntroductionThe National Institute for Health and Clinical Excellence guidelines recommend that breast reconstruction should be available to all women undergoing mastectomy and discussed at the initial surgical consultation (2002, and updated 2009). The National Mastectomy and Breast Reconstruction Audit (2009) showed that 21% of mastectomy patients underwent immediate breast reconstruction (IBR) and 11% had delayed breast reconstruction (DBR). Breast reconstruction has been shown to have a positive effect on quality of life postmastectomy. This retrospective study investigated the impact of the introduction of a dedicated oncoplastic multidisciplinary meeting (OP MDM) on our unit’s breast reconstruction rate.Patients and methodsA retrospective analysis of 229 women who underwent mastectomy, of whom 81 (35%) underwent breast reconstruction between April 2014 and March 2016. Data were analyzed before and after introduction of OP MDM in April 2015. Data on patient age, type of surgery (mastectomy only, mastectomy and reconstruction), timing of reconstruction (IBR, DBR), and type of reconstruction (implant, autologous) were collected.ResultsBetween April 2015 and March 2016, following establishment of OP multidisciplinary team in April 2015, of the 120 patients who had mastectomy, 50 (42%) underwent breast reconstruction with 78% (39/50) choosing IBR (56% implant reconstruction and 22% autologous). Compared to the period between April 2014 and March 2015 preceding the OP MDM, of 109 patients who underwent mastectomy, only 31 (28%) had breast reconstruction with 64% (20/31) choosing IBR (45% implant reconstruction and 19% autologous). The rate of DBR was lower, 22% (11/50), following OP MDM compared to 35% (11/31) before OP MDM.ConclusionThere has been an increased uptake of breast reconstruction surgery from 28% to 42%. The biggest impact was on those opting for the immediate type reconstruction option (78%). The OP MDM has significantly contributed to this increased rate of reconstruction.

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“…We recognize that several complex factors are associated with uptake of breast reconstruction following mastectomy (age, ethnicity, income, education, tumor characteristics, healthrelated issues, surgeon/hospital factors, and psychological or other factors). 4,[11][12][13][14][15][16] We are also aware that other factors may have contributed to this increased rate of uptake, including an increased trend in breast reconstruction nationally 9 and possible local logistical aspects (improved process in booking surgery, theater availability, and streamlined referral to plastic team); however, we believe that the introduction of the OP MDT was the key factor in this process and the comparative data in this study (Table 1) supports this assumption.…”

Section: Discussionmentioning

confidence: 54%

Improved immediate breast reconstruction as a result of oncoplastic multidisciplinary meeting

Lim

Gammal

2017

European Journal of Surgical Oncology (EJSO)

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Patients opting for breast reconstruction following mastectomy: an analysis of uptake rates and benefit

Cited by 30 publications

References 77 publications

Trends in breast reconstruction practices in a specialized breast tertiary referral centre

Trends in breast reconstruction practices in a specialized breast tertiary referral centre

Improved immediate breast reconstruction as a result of oncoplastic multidisciplinary meeting

Improved immediate breast reconstruction as a result of oncoplastic multidisciplinary meeting

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