Trends in post-mastectomy reconstruction: A SEER database analysis

Abstract

Background and Objectives This study was performed to investigate recent trends and factors associated with immediate breast reconstruction (IBR) using a large population-based registry. We hypothesized that rates of IBR have increased since passage of the Women’s Health and Cancer Rights Act of 1998. Methods The SEER (Surveillance, Epidemiology and End Results) database was used to evaluate Stage I–III breast cancer (BC) patients who underwent total mastectomy from 1998–2008. Univariate and multivariate analyses were performed to study predictors of IBR. Results Of 112,348 patients with BC treated by mastectomy, 18,001 (16%) had IBR. Rates of IBR increased significantly from 1998–2008 (p<0.0001). Use of IBR significantly decreased as patient age increased (p<0.0001), as stage increased (p<0.0001), and as the number of positive lymph nodes increased (p<0.0001). Estrogen receptor +/progesterone receptor + (ER+/PR+) patients had significantly higher IBR rates than ER−/PR− patients (p<0.0001). IBR was used in 3615 of 25,823 (14.0%) of patients having post-mastectomy radiation (XRT) and in 14,188 of 86,513 (16.4%) of those not having XRT (p<0.0001). Conclusions The utilization of IBR has increased significantly over the last decade. IBR was found to be significantly associated with age, race, geographical region, stage, ER, grade, LN status, and XRT (p<0.0001).

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

“…As recognition of the genetic component of familial breast cancer grows and genetic testing has become more available, rates of bilateral prophylactic mastectomy and contralateral prophylactic mastectomy have increased in high‐risk patients9 10. Furthermore, a trend has also been reported for women who are eligible for breast‐conserving surgery to opt for mastectomy3 11, 12, 13 and contralateral prophylactic mastectomy in the unaffected breast13, 14, 15, 16, 17, despite a lack of evidence of a survival advantage for this approach in the absence of a known genetic mutation.…”

Immediate Implant Reconstruction Is Associated With a Reduced Risk of Lymphedema Compared to Mastectomy Alone

“…12,13 Immediate breast reconstruction has been shown to improve body image, psychological well-being, and overall quality of life in breast cancer patients. 14–18 Numerous studies have demonstrated the oncologic safety of immediate breast reconstruction for patients with invasive breast cancer, 19–21 and some argue that immediate compared with delayed breast reconstruction offers superior aesthetic and psychosocial benefits.…”

Tolérance du lambeau de grand dorsal sans prothèse à la radiothérapie en reconstruction mammaire immédiate

“…Dans une récente méta-analyse, Gieni et al [6] rapportent l'absence de sur-risque observée dans les études rétrospectives observationnelles (793 patientes opérées par mastectomie avec RMI et comparées à 2917 patientes sans RMI), ainsi que dans les études rétrospectives avec appariements sur les paramètres histo-pronostiques des cancers (358 patientes avec RMI appariées au même nombre de patientes sans RMI). La sécurité carcinologique de la RMI étant démontrée, une augmentation croissante du nombre de procédure de RMI est observée avec l'année de prise en charge du cancer [2,4]. De même, concernant les délais à l'initiation des traitements adjuvants, la RMI est associée avec une augmentation modérée, cliniquement non significative, avec un délai supplémentaire moyen de 2 semaines environ en fonction des séries [16,17].…”

“…Le taux de reconstruction mammaire immédiate (RMI) est en augmentation régulière dans la plupart des pays développés [1][2][3][4], en raison de la preuve de son bénéfice sur le bien-être des patientes opérées par mastectomie pour cancer du sein et de son innocuité carcinologique [5,6]. Parmi les techniques de reconstruction, le lambeau de grand dorsal sans prothèse (LGDSP) est une technique fiable qui donne d'excellents résultats en reconstruction mammaire.…”