Increasing Rates but Persistent Variability of Immediate Breast Reconstruction: Real-Time Data from a...

Area of Science:

• Oncology
• Plastic Surgery
• Public Health

Background:

• Breast reconstruction after mastectomy significantly improves patient quality of life.
• Immediate breast reconstruction (IBR) is a key consideration for breast cancer patients.

Purpose of the Study:

• To provide an updated overview of IBR trends in the Netherlands over the last decade.
• To analyze factors associated with IBR use and hospital variations.

Main Methods:

• Analysis of nationwide data from the Dutch Breast Cancer Audit (NBCA) from 2012 to 2022.
• Inclusion of patients who underwent mastectomy for ductal carcinoma in situ (DCIS) or invasive breast cancer.
• Primary outcome: incidence and trends of IBR; Secondary outcomes: associated factors and hospital variations.

Main Results:

• IBR use for DCIS increased from 39% (2012) to 48% (2022); associated with younger age and lower grade.
• IBR use for invasive breast cancer increased from 16% (2012) to 29% (2022); associated with younger age, neoadjuvant chemotherapy, and no adjuvant radiotherapy.
• Significant variations in IBR application were observed among Dutch hospitals.

Conclusions:

• While IBR use has increased, disparities in its application across hospitals remain.
• Further prospective research is underway to understand and address these national variations.
• The goal is to promote a more equitable distribution of IBR services nationwide.