Impact of Regional Referral Centers for Microsurgical Breast Reconstruction: The New England Perforator Flap Program Experience

Yueh, Janet H.; Slavin, Sumner A.; Bar-Meir, Eran; Merali, Hasan S.; Houlihan, Mary Jane; Gautam, Shiva; Morris, Donald J.; Tobias, Adam M.; Lee, Bernard T.

doi:10.1016/j.jamcollsurg.2008.10.033

Cited by 23 publications

(24 citation statements)

References 13 publications

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“…25 Academic centers provide subspecialty care, which may affect referral patterns, and also possess extra resources, including residents, skilled nursing staff, and financial incentives, which may promote reconstruction. 11,21,23,24,26–28 Alternatively, women may choose academic centers because of their reputation, prestige, or research notoriety.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Travel Distance on Breast Reconstruction in the United States

Albornoz

Cohen

Razdan

et al. 2016

Plastic and Reconstructive Surgery

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Background Inadequate access to breast reconstruction was a motivating factor underlying passage of the Women’s Health and Cancer Rights Act. It remains unclear whether all patients interested in breast reconstruction undergo this procedure. The aim of this study was to determine whether geographic disparities are present that limit the rate and method of postmastectomy reconstruction. Methods Travel distance in miles between the patient’s residence and the hospital reporting the case was used as a quantitative measure of geographic disparities. The American College of Surgeons National Cancer Database was queried for mastectomy with or without reconstruction performed from 1998 to 2011. Reconstructive procedures were categorized as implant or autologous techniques. Standard statistical tests including linear regression were performed. Results Patients who underwent breast reconstruction had to travel farther than those who had mastectomy alone (p < 0.01). A linear correlation was demonstrated between travel distance and reconstruction rates (p < 0.01). The mean distances traveled by patients who underwent reconstruction at community, comprehensive community, or academic programs were 10.3, 19.9, and 26.2 miles, respectively (p < 0.01). Reconstruction rates were significantly greater at academic programs. Patients traveled farther to undergo autologous compared with prosthetic reconstruction. Conclusions Although greater patient awareness and insurance coverage have contributed to increased breast reconstruction rates in the United States, the presence of geographic barriers suggests an unmet need. Academic programs have the greatest reconstruction rates, but are located farther from patients’ residences. Increasing the number of plastics surgeons, especially in community centers, would be one method of addressing this inequality.

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Section: Discussionmentioning

confidence: 99%

The Impact of Travel Distance on Breast Reconstruction in the United States

Albornoz

Cohen

Razdan

et al. 2016

Plastic and Reconstructive Surgery

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“…With the development of perforator flap programs, women are actively seeking the latest innovation in breast reconstruction; however, little study exists examining patient satisfaction with perforator flaps. 22 Our study examined the general and aesthetic satisfaction of 439 women with postmastectomy breast reconstruction. Overall, when assessing patient satisfaction across all four reconstructive options, DIEP and pedicle TRAM flap patients reported the highest satisfaction rates.…”

Section: Discussionmentioning

confidence: 99%

Patient Satisfaction in Postmastectomy Breast Reconstruction: A Comparative Evaluation of DIEP, TRAM, Latissimus Flap, andImplant Techniques

Yueh

Slavin²,

Adesiyun³

et al. 2010

Plastic and Reconstructive Surgery

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199

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“…We retrospectively reviewed the charts of all women who underwent initial BR at the Beth Israel Deaconess Medical Center (BIDMC) between January 1999 and December 2006 (9). This study was approved by the hospital's institutional review board.…”

Section: Patient Populationmentioning

confidence: 99%