Regional variation in use of immediate breast reconstruction after mastectomy for breast cancer in England

Abstract

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

“…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.…”

“…Recent guidelines5 6 recommend that reconstruction should be discussed and offered as an option for the majority of women undergoing mastectomy. Postmastectomy breast reconstruction (PMBR) has thus been incorporated into the contemporary surgical management of patients with breast cancer, resulting in increasing reconstruction rates, as reported in national audits of populations in both the UK and USA7 8.…”

Breast reconstruction after mastectomy for breast cancer

“…12,13,16,17,18,[20][21][22][23][24][25][26][27][28]30 This is in part because of concern about increased complication rates with age and comorbidities. In an attempt to identify predictors of breast reconstruction using the hospitalbased national sample of inpatients from 1999-2003, Reuben and colleagues 27 found that the association between age and breast reconstruction remained significant after controlling for comorbidities.…”

“…13,19 We identified six studies from other jurisdictions, four of which were English-language publications (Table 3). [28][29][30][31] Australia, Denmark and England reported national rates of breast reconstruction of 9.9% (1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000), 14% (1999-2006) and 16.5% (2006-2009), respectively. [28][29][30] A study from a single institution in Shanghai, China, reported an increase in the rate of reconstruction from 1.3% in 1990 to 5.1% in 2005.…”

“…[28][29][30][31] Australia, Denmark and England reported national rates of breast reconstruction of 9.9% (1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000), 14% (1999-2006) and 16.5% (2006-2009), respectively. [28][29][30] A study from a single institution in Shanghai, China, reported an increase in the rate of reconstruction from 1.3% in 1990 to 5.1% in 2005. 31 These authors reported the rate of breast reconstruction in China as a proportion of all patients with breast cancer, whereas the other studies included in this review reported the rate as a percentage of patients who had undergone mastectomy.…”