Racial Disparities in Postoperative Breast Reconstruction Outcomes: A National Analysis

Johnstone, Thomas; Thawanyarat, Kometh; Rowley, Mallory; Francis, Shannon; Camacho, Justin M; Singh, Dylan; Navarro, Yelissa; Shah, Jennifer; Nazerali, Rahim

doi:10.1007/s40615-023-01599-1

Cited by 10 publications

(2 citation statements)

References 44 publications

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“…Furthermore, there seems to be an acute desire in smaller-breasted women for mastectomy vs. lumpectomy and oncoplastic reconstruction when compared to other parts of the world. Barriers to receiving both OPS and post-mastectomy reconstruction in the USA are multifactorial and include major healthcare systems-based issues such as access to healthcare, insurance status, race/ethnicity, socioeconomic status, geographic location, surgeon factors, and appropriate referral to a plastic surgeon ( 10 - 12 ). Access to a plastic surgeon can further propagate inequality in breast cancer care, thus, the need for continued education and streamlined training of general surgeons, breast surgeons, and plastic surgeons, on the principles and maintained safety of OPS, is paramount for women with breast cancer in the USA.…”

Section: Introductionmentioning

confidence: 99%

Oncoplastic surgery in the USA: a review of where we started, where we are today and where we are headed

Willcox,

Losken,

Garcia Nores

2024

Gland Surg

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The surgical management of breast cancer has evolved tremendously over the last century and now includes oncoplastic techniques that improve both cosmetic and oncologic outcomes for patients. The purpose of this review is to provide the reader with a broad overview of the history of oncoplastic breast surgery in the United States (USA), and to summarize important patient factors and technical innovations for optimal operative planning in the era of multimodal treatment of breast cancer. The indications for oncoplastic surgery (OPS) have broadened significantly as more women pursue breast conservation with preservation of their native breast tissue. The operative philosophy of OPS is based on fundamental reconstructive principles, with technique selection based largely on tumor size and location. Reduction mammoplasty and mastopexy techniques have become some of the most utilized procedures in OPS due to their versatility to address tumors in almost all areas of the breast. Volume replacement techniques with locoregional perforator flaps continue to gain popularity as a single-stage reconstructive option for women with large tumor to breast ratios, especially with specialized plastic surgeons at high volume, academic centers. The oncologic advantages of OPS have allowed women to avoid mastectomy with improved margin control, re-excision rates, and equivalent overall survival all while preserving the aesthetic outcomes for these patients. Despite the proven benefits of OPS, numerous healthcare systems barriers including insurance status, geographic location, referral patterns, and racial disparities all continue to play a role in access to surgical sub-specialized breast oncology care demonstrating the need for ongoing research and education about oncoplastic principles.

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Section: Introductionmentioning

confidence: 99%

Oncoplastic surgery in the USA: a review of where we started, where we are today and where we are headed

Willcox,

Losken,

Garcia Nores

2024

Gland Surg

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“…(7) However, exact numbers are unknown as current literature re ecting racial disparities rarely report reconstruction rates in NA/AI women alone, often including them as "other" along with Asian and Paci c Islander women. (9)(10)(11)(12)(13)(14)(15)(16) Institutional experience suggests that these rates may be lower, with only 9% of women pursuing BR at a regional cancer center (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Perceptions of Breast Reconstruction Among Native American Women: A Qualitative Analysis

Marquez,

Tausinga,

Scott

et al. 2023

Preprint

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Background Despite having a high incidence of breast cancer, Native American/American Indian (NA/AI) women have among the lowest rates of breast reconstruction (BR). While NA/AI women are often racially miscategorized, little is known as to why reconstruction rates remain low. This study investigates cultural factors, values, and perceptions of held by NA/AI that might impact BR rates. Methods Individual, semi-structured interviews utilizing open-ended questions prompting for insight into barriers to care, cultural values, body image, and reconstructive preferences were conducted. All interviews were audio-recorded and transcribed. Qualitative content analysis was performed, which allowed for inductive themes to be drawn from the raw data. Results Fifteen NA/AI women who underwent surgical treatment for breast cancer were interviewed. Emerging themes included acceptance, privacy, humility, wholeness, self-image, negative perceptions of plastic surgery, naturality, fear, and cultural contraindication of ADM use. All women discussed their reconstructive options with a breast surgeon, but only 3 chose to reconstruct. Most women suggested that reconstruction with autologous tissue was a more culturally congruent choice than implant-based reconstruction. Reconstructive surgery was often viewed as strictly cosmetic. All women unanimously opposed ADM use in BR due to cultural beliefs surrounding the use of tissue from deceased individuals. Conclusions This is the first study to investigate culture-specific perceptions of BR. Our results suggest that culture specific factors and preferences may contribute to low rates of BR. Results from this study can be used to improve cultural competency in addressing BR in NA/AI women.

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Racial Disparities in Breast Cancer: from Detection to Treatment

Chen,

Stover,

Ballinger

et al. 2023

Curr Oncol Rep

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Racial Disparities in Postoperative Breast Reconstruction Outcomes: A National Analysis

Cited by 10 publications

References 44 publications

Oncoplastic surgery in the USA: a review of where we started, where we are today and where we are headed

Oncoplastic surgery in the USA: a review of where we started, where we are today and where we are headed

Perceptions of Breast Reconstruction Among Native American Women: A Qualitative Analysis

Racial Disparities in Breast Cancer: from Detection to Treatment

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