Findings of a national comparative audit of mastectomy and breast reconstruction surgery in England

Jeevan, Ranjeet; Cromwell, David; Browne, John; Caddy, Christopher M.; Pereira, Jerome; Sheppard, Carmel; Greenaway, Kimberley; Meulen, Jan van der

doi:10.1016/j.bjps.2014.04.022

Cited by 193 publications

(226 citation statements)

References 13 publications

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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.…”

Section: Discussionmentioning

confidence: 72%

“…Earlier in the study period, autologous flaps were the most widely used. However, over time, implant‐based reconstructions have become more common3 7, 22 34, 35, 36. This may be explained by implant reconstructions requiring less complicated operations and shorter operating times, lack of donor‐site morbidity and no requirement for microvascular surgery expertise as in the case of some autologous procedures (DIEP flaps).…”

Section: Discussionmentioning

confidence: 99%

“…Although significant progress has been made in the multimodal management of breast cancer, complete surgical resection with disease‐free margins remains the cornerstone of effective therapy. To achieve adequate locoregional control, approximately 40 per cent of patients have a total mastectomy2 3. For these patients, breast reconstruction is proven to improve psychosocial and aesthetic outcomes4.…”

Section: Introductionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…5 Data on surgical procedures and patient characteristics were prospectively recorded for women aged 16 years and over with a diagnosis of invasive carcinoma of the breast, or ductal carcinoma in-situ, undergoing mastectomy with immediate reconstruction or primary delayed reconstruction following a previous mastectomy. Written consent to participate in a follow-up survey was also obtained.…”

Section: Methodsmentioning

confidence: 99%

Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction

Browne

Jeevan

Pusic

et al. 2018

Journal of Plastic, Reconstructive & Aesthetic Surgery

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A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer

et al. 2017

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A major challenge in value-based health care is the lack of standardized health outcomes measurements, hindering optimal monitoring and comparison of the quality of health care across different settings globally. The International Consortium for Health Outcomes Measurement (ICHOM) assembled a multidisciplinary international working group, comprised of 26 health care providers and patient advocates, to develop a standard set of value-based patient-centered outcomes for breast cancer (BC). The working group convened via 8 teleconferences and completed a follow-up survey after each meeting. A modified 2-round Delphi method was used to achieve consensus on the outcomes and case-mix variables to be included. Patient focus group meetings (8 early or metastatic BC patients) and online anonymized surveys of 1225 multinational BC patients and survivors were also conducted to obtain patients' input. The standard set encompasses survival and cancer control, and disutility of care (eg, acute treatment complications) outcomes, to be collected through administrative data and/or clinical records. A combination of multiple patient-reported outcomes measurement (PROM) tools is recommended to capture long-term degree of health outcomes. Selected case-mix factors were recommended to be collected at baseline. The ICHOM will endeavor to achieve wide buy-in of this set and facilitate its implementation in routine clinical practice in various settings and institutions worldwide.

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Findings of a national comparative audit of mastectomy and breast reconstruction surgery in England

Cited by 193 publications

References 13 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

Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction

A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer

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