Rural-Urban Differences in Breast Reconstruction Utilization Following Oncologic Resection

Area of Science:

• Oncology
• Plastic Surgery
• Health Services Research

Background:

• Breast reconstruction (BR) aims to restore form and function after mastectomy.
• Disparities in BR access and utilization may exist, particularly for rural populations.

Purpose of the Study:

• To investigate disparities in breast reconstruction rates among female patients in Kentucky based on geographic location (rural vs. urban).

Main Methods:

• Retrospective population-based cohort study (2006-2015) of breast cancer patients (Stages I-III) treated with mastectomy.
• Geographic stratification using 2013 Beale codes.
• Chi-square tests and multivariate logistic regression to analyze BR likelihood by rural-urban status.

Main Results:

• Overall, 21.5% of 10,032 eligible patients underwent BR.
• BR rates were 31.1% for urban, 20.4% for near-metro, and 13.4% for rural patients (P < .001).
• Rural (OR 0.36) and near-metro (OR 0.54) women were significantly less likely to receive BR than urban women.

Conclusions:

• Women in rural Kentucky experience lower rates of breast reconstruction compared to their urban counterparts.
• This indicates a disparity in access to BR for rural populations.
• Efforts are needed to ensure equitable access to breast reconstruction for all patients, regardless of geographic location.