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Updated: Jan 26, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Applying a value-based care framework to post-mastectomy reconstruction.

Clifford C Sheckter1, Evan Matros2, Gordon K Lee1

  • 1Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, CA, USA.

Breast Cancer Research and Treatment
|April 3, 2019
PubMed
Summary
This summary is machine-generated.

Reconstructive surgeons are shifting to value-based care, focusing on outcomes and costs. A new framework for breast reconstruction aims to optimize value by considering patient outcomes and efficiency.

Keywords:
Breast reconstructionHealth policyMastectomyValue-based care

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Area of Science:

  • Health economics
  • Surgical outcomes research
  • Value-based healthcare

Background:

  • The healthcare industry is transitioning from volume-based to value-based reimbursement models.
  • Value in healthcare is defined as the ratio of healthcare outcomes to costs.
  • Reconstructive surgeons must adapt to this shift, particularly in procedures like post-mastectomy breast reconstruction.

Purpose of the Study:

  • To develop a value-based care framework specifically for reconstructive surgery.
  • To utilize post-mastectomy breast reconstruction as a model for this framework.
  • To define key components of value in reconstructive surgery, including outcomes and costs.

Main Methods:

  • Application of a pre-existing value framework to breast reconstruction.
  • Inclusion of expert opinion and comprehensive literature review.
  • Construction of domains and realization strategies based on health economic principles.

Main Results:

  • Identification of seven key domains for a value-based framework.
  • These domains include stakeholder engagement, clear treatment goals, patient-centered care, continuum optimization, operational efficiency, and scaling best practices.
  • The framework emphasizes a holistic approach to value in reconstructive surgery.

Conclusions:

  • Reconstructive plastic surgeons will likely face fixed reimbursement models, such as bundled payments.
  • Adopting a value-based approach to breast reconstruction is crucial for surgeons to adapt and succeed.
  • This work aims to promote the assessment and integration of value within the specialty of reconstructive surgery.