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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Outpatient mastectomy and breast reconstructive surgery
John Bian1, Helen Krontiras, Jeroan Allison
1HSR&D, Atlanta VA Medical Center, 1670 Clairmont Road, Decatur, Georgia 30033, USA. john.bian@va.gov
Annals of Surgical Oncology
|January 1, 2008
Summary
Outpatient mastectomy significantly lowers breast reconstruction rates compared to inpatient procedures. This disparity is more pronounced in minority breast cancer patients, necessitating further research into care setting choices.
Area of Science:
- Oncology
- Surgical Oncology
- Health Services Research
Background:
- Post-mastectomy breast reconstruction is a mandated benefit in the US.
- Outpatient mastectomy may impact post-mastectomy care and reconstruction rates.
- Concerns exist regarding adequate care following outpatient mastectomies.
Purpose of the Study:
- To examine the association between outpatient mastectomy and the likelihood of receiving breast reconstruction.
- To identify factors influencing breast reconstruction rates after mastectomy.
Main Methods:
- Utilized SEER-Medicare data for women aged 65-69 diagnosed with early-stage breast cancer (1998-2002).
- Analyzed surgery delivery settings (inpatient vs. outpatient) using claims data.
- Employed multivariable logistic regression to assess reconstruction likelihood within 4 months of diagnosis.
Main Results:
- Outpatient mastectomy patients had significantly lower reconstruction rates (4%) compared to inpatient (13%).
- Outpatient mastectomy was associated with a reduced likelihood of reconstruction (OR=0.247).
- African American patients were less likely to receive reconstruction than white patients (OR=0.515).
Conclusions:
- Outpatient mastectomy is linked to decreased utilization of breast reconstruction.
- Further research should investigate mastectomy delivery settings, focusing on younger and minority populations.
- Understanding patient and provider choices regarding mastectomy settings is crucial.