Have We Expanded the Equitable Delivery of Postmastectomy Breast Reconstruction in the New Millennium? Evidence from the National Cancer Data Base

Sisco, Mark; Du, Hongwu; Warner, Jeremy P.; Howard, Michael A.; Winchester, David P.; Yao, Katharine

doi:10.1016/j.jamcollsurg.2012.07.008

Cited by 139 publications

(108 citation statements)

References 38 publications

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“…In contrast to most other studies [26,29,43], we found this group to be more likely to receive reconstruction than women with a Danish ethnic background. It should be noted here that the definition of ethnicity is based on citizenship, and in the present study, non-Danish ethnicity thus constitutes a culturally heterogeneous group.…”

Section: Discussioncontrasting

confidence: 99%

Socio-demographic, clinical, and health-related factors associated with breast reconstruction – A nationwide cohort study

et al. 2015

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Keywords:Breast reconstruction Breast cancer Surgery Mastectomy Information given Socio-demographic factors a b s t r a c tWe collected registry-and questionnaire-based data on socio-economic and health status, tumor-and treatment-related variables, and explored associations with receipt of reconstruction and information about treatment options in a nationwide cohort of Danish women, treated for primary breast cancer.A total of 594 women were available for analysis, 240 (40%) of these received reconstruction.Multivariate analyses showed that receipt of reconstruction was associated with 1) younger age at time of primary surgery (<36 years: OR ¼ 10.04, [3.80e26.50], p < 0.001 and 36e49 years: OR ¼ 2.48, [1.73e3.56], p < 0.001, compared to 50e60 year olds), 2) having received radiotherapy (OR ¼ 0.57, [0.40 e0.81], p ¼ 0.002), 3) high income (Second quartile: OR ¼ 1.74, [1.05e2.90], p ¼ 0.033 and fourth quartile: OR ¼ 2.18, [1.31e3.62], p ¼ 0.003, compared with the lowest income quartile), and 4) ethnicity other than Danish (OR ¼ 6.32, [1.58e25.36], p ¼ 0.009).Health-related factors at the time of primary surgery (physical functioning, body mass index, smoking, use of alcohol, and comorbidity) were not associated with reconstruction. Odds of having received information about the option of reconstruction decreased by 8% per year of age in the multivariate analysis (OR ¼ 0.92, [0.87e0.97], p ¼ 0.003).In conclusion, younger age and not having been treated with radiotherapy was independently associated with reconstruction. In addition, higher income was also found to be associated with reconstruction despite free and equal access to reconstruction and healthcare in Denmark. Healthrelated factors were not associated with the use of reconstruction following mastectomy. Our findings underscore the need for physicians to ensure optimal level of information and accessibility to reconstruction for all women regardless of age, treatment, and socio-economic status.

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Section: Discussioncontrasting

confidence: 99%

Socio-demographic, clinical, and health-related factors associated with breast reconstruction – A nationwide cohort study

et al. 2015

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“…The large number of cases allows for robust evaluation of practice and outcomes in common cancers and for the study of rare cancers with numbers of cases that are often an order of magnitude greater than institution-based series. [9][10][11][12][13][14][15] The NCDB may also be used to study disparities and to direct policy. One study conducted by the American Cancer Society demonstrated that patients who lacked health insurance had a poorer outcome with any stage of cancer compared with patients with private insurance.…”

Section: Use Of the Ncdb For Evaluation Of Quality Of Carementioning

confidence: 99%

Using the American College of Surgeons Cancer Registry to Drive Quality

Edge

McKellar

Stewart

2013

JOP

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“…Paradoxically, in recent years, however, an increase in the percentage of mastectomies has been observed, which can be explained by the availability of mammary reconstruction and the improvement of postoperative results, especially immediate ones, the increase in the number of women who undergo genetic testing, the desire for prophylactic contralateral breast surgery to reduce the risk (which is frequently over-assessed by the patient) and anxiety, and last but not least, the more and more often use of nuclear magnetic resonance for the diagnosis of breast cancer (19).…”

mentioning

confidence: 99%

Breast Cancer Surgery

Blidaru¹

2017

chr

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Breast cancer treatment has been constantly improving over the past decades and the consequences of this have been an increase in survival and improvements in the quality of life of these patients. The main reasons for this are early screening and diagnosis, more accurate characterization of mammary tumours by histopathological, molecular and genomic examination in order to obtain a personalized treatment, the emergence of new molecules for systemic treatment, the improvement of radiotherapy and the progress of surgical techniques.The "modern" history of breast cancer surgery begins, of course, with W. Halsted and the radical mastectomy type of surgery that bears his name, and which has been for nearly 50 years synonymous with the surgical treatment of breast cancer. This surgery represented the model to be followed for radical cancer treatment.Attempts at supraradical mastectomy proposed by DahlIversen, Wangesteen, and Urban did not improve survival, and were quickly abandoned due to increased morbidity and mortality. The transition from radical mastectomy to successive forms of modified mastectomy was surprisingly slow, with every change virtually representing a revolution, even if these changes in technique were not paradigm replacements, as they were in fact faithful to the same Halstedian concept of oncological radicality. Their common desideratum was complete axillary dissection, striving to achieve this by initially preserving the pectoralis major muscle, then both major and minor pectoralis muscles. Halsted mastectomy was replaced by Patey and afterwards by Madden technique, the latter being at present the most commonly used mastectomy type (1).

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Have We Expanded the Equitable Delivery of Postmastectomy Breast Reconstruction in the New Millennium? Evidence from the National Cancer Data Base

Cited by 139 publications

References 38 publications

Socio-demographic, clinical, and health-related factors associated with breast reconstruction – A nationwide cohort study

Socio-demographic, clinical, and health-related factors associated with breast reconstruction – A nationwide cohort study

Using the American College of Surgeons Cancer Registry to Drive Quality

Breast Cancer Surgery

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