Immediate Reconstruction after Mastectomy for Breast Cancer: Which Factors Affect Its Course and Final Outcome?

Fernández-Frías, Ana; Aguilar, José; Sánchez, Juan A.; Merck, Belén; Piñero, Antonio; Calpena, Rafael

doi:10.1016/j.jamcollsurg.2008.09.005

Cited by 18 publications

(33 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with private/health maintenance organization insurance were more likely to get immediate reconstruction in comparison with patients having government-sponsored insurance, such as Medicare and Medicaid. 7,8 However, Panieri et al studied a smaller group and found quite the opposite, with no association between immediate reconstruction, age, occupation, education level, and marital status. Patients in this study preferred to have simpler procedures, and expressed less concern for their postoperative appearance.…”

Section: Disparities and Psychologic Effects Of Mastectomymentioning

confidence: 99%

“…7 Patients requesting reconstruction to maintain their body image should be made aware that the reconstructed breast will not look exactly like their natural breast. 6 Faced with such knowledge, the patient should make a decision whether or not to pursue reconstruction, and specifically which type of surgery she would prefer.…”

Section: Disparities and Psychologic Effects Of Mastectomymentioning

confidence: 99%

“…6 Faced with such knowledge, the patient should make a decision whether or not to pursue reconstruction, and specifically which type of surgery she would prefer. 7 The decision to get immediate breast reconstruction versus delayed reconstruction or avoiding reconstruction altogether has been related to patient demographics. Reuben et al demonstrated that immediate reconstruction was more likely to happen in the younger (less than 50 years) white patient who was seeking medical care in an urban versus a rural hospital.…”

Section: Disparities and Psychologic Effects Of Mastectomymentioning

confidence: 99%

“…8 These patients were also more likely to be educated, employed, and married. 7,8 However, recently there has been an increase in breast reconstruction among older patients (greater than 65 years), probably related to greater awareness and changes in provider bias. 8 Patients who did not undergo immediate reconstruction were more likely to be older, with multiple comorbidities and receiving care in a nonteaching hospital.…”

Section: Disparities and Psychologic Effects Of Mastectomymentioning

confidence: 99%

See 3 more Smart Citations

Breast reconstruction: current and future options

Paul

Prendergast

Nicholson

et al. 2011

BCTT

View full text Add to dashboard Cite

Abstract:When initiated by the devastating diagnosis of cancer, post ablative breast restoration has at its core the goal of restoring anatomic normalcy. The concepts of body image, wholeness, and overall well-being have been introduced to explain the paramount psychological influence the breast has on both individuals and society as a whole. Hence, a growing subspecialty has been established to recreate or simulate the lost breast. At least one third of breast cancer victims consider breast reconstruction. Breast reconstruction post mastectomy may be offered at the time of mastectomy or delayed post mastectomy after adjuvant therapy. This may be utilizing autologous tissues or implants and each has risks and benefits, especially when considering adjuvant therapy. In addition, there has been a move away from a traditional mastectomy to less invasive, but still curative procedures, such as skin-sparing and nipple-sparing mastectomy. These procedures provide the breast envelope to facilitate reconstruction. This paper reviews the primary issues in breast reconstruction, as well as their psychologic, oncologic, and social impact. Keywords: breast restoration, body image, breast reconstruction, mastectomy History of breast reconstructionBreast cancer is the second leading cause of cancer-related death among females in the US, and affects one in eight women in their lifetime.1,2 Advances in medical research have dramatically improved the treatment of this disease over the last 50 years. In addition to chemotherapy and radiation therapy, partial and complete mastectomy of diseased and contralateral breasts has become more frequent. However, these surgical modalities often leave patients with anatomical deformities and altered body image, along with the psychologic impact. 3,4 Breast reconstruction is a dynamic and multidisciplinary approach that has grown into a solution for many breast cancer patients treated with surgery. Breast reconstruction began as a means to reduce chest wall complications and deformities from mastectomy, with the goal to recreate symmetry and contour while avoiding delay in adjuvant cancer treatment.1 Breast reconstruction was introduced over a century ago as a surgical modality for rebuilding the anatomic breast using autologous tissues and prosthetic implants. 2,5

show abstract

Section: Disparities and Psychologic Effects Of Mastectomymentioning

confidence: 99%

Section: Disparities and Psychologic Effects Of Mastectomymentioning

confidence: 99%

Section: Disparities and Psychologic Effects Of Mastectomymentioning

confidence: 99%

Section: Disparities and Psychologic Effects Of Mastectomymentioning

confidence: 99%

See 2 more Smart Citations

Breast reconstruction: current and future options

Paul

Prendergast

Nicholson

et al. 2011

BCTT

View full text Add to dashboard Cite

show abstract

“…Current data indicate that complications develop in more than 40% of patients undergoing post-mastectomy radiotherapy [18]. Although radiotherapy by itself is not an absolute contraindication for breast reconstruction, some authors recommend delaying the breast reconstruction procedure until radiotherapy has been administered, because it improves the chances of obtaining favorable cosmetic results, and avoids difficulties related to the optimal radiation delivery after an immediate reconstruction [18,19].…”

Section: Rm and Breast Reconstructionmentioning

confidence: 99%

Surgical treatment of breast cancer in young women

Piñero-Madrona

2010

Breast Cancer Res Treat

View full text Add to dashboard Cite

Influence of health insurance, hospital factors and physician volume on receipt of immediate post-mastectomy reconstruction in women with invasive and non-invasive breast cancer

Hershman

Richards

Kalinsky

et al. 2012

Breast Cancer Res Treat

View full text Add to dashboard Cite

For women with breast cancer who undergo mastectomy, immediate breast reconstruction (IR) offers a cosmetic and psychological advantage. We evaluated the association between demographic, hospital, surgeon and insurance factors and receipt of IR. We conducted a retrospective hospital-based analysis with the Perspective database. Women who underwent a mastectomy for invasive breast cancer (IBC) and ductal carcinoma in situ (DCIS) from 2000 to 2010 were included. Logistic regression analysis was used to determine factors predictive of IR. Analyses were stratified by age (<50 vs. ≥50) and IBC versus DCIS. Of the 108,992 women with IBC who underwent mastectomy, 30,859 (28.3 %) underwent IR, as compared to 6,501 (44.2 %) of the 14,710 women with DCIS who underwent mastectomy underwent IR. In a multivariable model for IBC, increasing age, black race, being married, rural location, and increased comorbidities were associated with decreased IR. Odds ratios (OR) of IR increased with commercial insurance (OR 3.38) and Medicare (OR 1.66) insurance (vs. self-pay), high surgeon-volume (OR 1.19), high hospital-volume (OR 2.24), and large hospital size (OR 1.20). The results were identical for DCIS, and by age category. The absolute difference between the proportion of patients who received IR with commercial insurance compared to other insurance, increased over time. Immediate in-hospital complication rates were higher for flap reconstruction compared to implant or no reconstruction (15.2, 4.0, and 6.1 %, respectively, P <.0001). IR has increased significantly over time; however, modifiable factors such as insurance status, hospital size, hospital location, and physician volume strongly predict IR. Public policy should ensure that access to reconstructive surgery is universally available.

show abstract

Immediate Reconstruction after Mastectomy for Breast Cancer: Which Factors Affect Its Course and Final Outcome?

Cited by 18 publications

References 60 publications

Breast reconstruction: current and future options

Breast reconstruction: current and future options

Surgical treatment of breast cancer in young women

Influence of health insurance, hospital factors and physician volume on receipt of immediate post-mastectomy reconstruction in women with invasive and non-invasive breast cancer

Contact Info

Product

Resources

About