Background: Breast reconstruction (BR) has psychosocial and sexual well-being benefits in breast cancer (BC) patients that undergo mastectomy. However, this practice remains infrequent in many low-and middle-income countries as it is not usually covered by public health insurance schemes. This study aims to determine the prevalence and main predictors of BR among BC patients treated in a public center in Mexico.Methods: Medical records of women diagnosed with primary BC from 2009 to 2020 at a center in Monterrey, Mexico were reviewed. Patients who underwent a mastectomy and had at least a 2-year follow-up were included. Fisher's exact and logistic regression tests were employed to determine variable associations.Results: A total of 586 patients with a median age of 50 years (range 20-88) were included. The majority of patients were in a relationship (67%), postmenopausal (58%), and had a BMI 25 kg/m 2 (80%). Most common stages at diagnosis were II (44%) and III (41%). Overall, 54 (9%) received BR (41% immediate and 59% delayed). Predictors for undergoing BR were stages 0-I at diagnosis (OR 2.13, 95%CI 1.10-4.10; p¼0.024), age <40 years (OR 2.15, 95%CI 1.10-4.22; p¼0.026), premenopausal status (OR 2.62, 95%CI 1.45-4.73; p¼0.001), not receiving adjuvant radiotherapy (RT) (OR 2.34, 95%CI 1.30-4.21; p¼0.005), BMI <25 kg/m 2 (OR 2.62, 95%CI 1.44-4.74; p¼0.002), negative lymph node (LN) status (OR 2.47, p¼0.004), and bilateral mastectomy (OR 4.08, p<0.001). In a multivariate analysis, menopausal status, BMI, not receiving adjuvant RT, and bilateral mastectomy remained independent predictors for BR. Of note, no significant association was found between BR and type of LN surgery (axillary dissection v sentinel biopsy, p¼0.123).Conclusions: BR is one of the foremost strategies to improve BC survivors' quality of life. However, its uptake remains low in resource-constrained settings, possibly due to its high economic cost and information gaps among patients. Further studies are needed to identify other potential factors that influence BR uptake. The development of interventions that tackle the barriers limiting patients' adequate and equitable access to this procedure is urgently needed.Legal entity responsible for the study: The authors.
