Factors Influencing the Rate of Post-Mastectomy Breast Reconstruction in a Canadian Teaching Hospital. Issue 4 (November 2017)

• Record Type: Journal Article
• Authors: Karunanayake, Mihiran; Bortoluzzi, Patricia; Chollet, André; Lin, Jenny C.
• Is Part Of: Plastic surgery. Volume 25:Issue 4(2017)
• Page Start: 242
• Page End: 248
• Publication Date: 2017-11
• Subjects: breast reconstruction -- autologous breast reconstruction -- rate of breast reconstruction -- breast cancer -- quality of life -- prosthetic breast reconstruction; Surgery, Plastic -- Periodicals; Surger, Plastic; Surgery, Plastic; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 617.95005
• DOI: 10.1177/2292550317728034
• Languages: English
• ISSNs: 2292-5503

Abstract

Background: Post-mastectomy breast reconstruction (PMBR) improves psychosocial well-being, quality of life, and body image. Reconstruction rates vary widely (up to 42% in the United States), but the few Canadian studies available report rates of 3.8% to 7.9%. We sought to evaluate the current state of breast reconstruction in 1 Canadian teaching hospital and factors determining patients' access to reconstruction. Methods: We performed a retrospective chart review of all patients with breast cancer undergoing mastectomy alone or mastectomy and reconstruction at a Canadian hospital between 2010 and 2013. We calculated rates of breast reconstruction and compared patient characteristics between the 2 groups, and then performed a multiple logistic regression to determine factors increasing the odds of receiving breast reconstruction. Results: A total of 152 patients underwent 154 total or modified radical mastectomies. We obtained a rate of PMBR of 21%, 14% immediate reconstruction, and 8% delayed. Statistical analysis showed that compared to patients with mastectomy alone, patients who received PMBR were significantly younger, with a larger percentage having bilateral mastectomies, non-invasive breast cancer, and residing further from the hospital. Patients less than 50 years old and those with bilateral mastectomies had significantly greater odds of having a reconstruction. Conclusions: Our Canadian tertiary care institution has a high volume of breast surgery and an active breast reconstruction team. However, the rate of immediate reconstruction remains low compared to similar centers in the United States. We recommend a united effort to increase awareness regarding PMBR and address common misconceptions hindering patients' access to breast reconstruction. Level of Evidence: Epidemiologic study, Level III