BACKGROUND: Many factors influence whether breast cancer patients undergo reconstruction after mastectomy. This study was undertaken to determine the patterns of care and variables associated with the use of reconstruction for ductal carcinoma in situ (DCIS) and to compare previous results for invasive carcinoma. METHODS: Postmastectomy reconstruction rates were collected from the California Office of Statewide Health Planning and Development (OSHPD) for 2003-2007. International Classification of Disease-9 codes were used to identify patients undergoing reconstruction after mastectomy. Variations in reconstruction rates were examined by type of breast cancer (DCIS vs. invasive), calendar year, age, type of insurance, type of hospital, and race/ethnicity. Univariate and multivariate odds ratios (OR) with 95% confidence intervals (CI) were estimated for relative odds of immediate reconstruction versus mastectomy only. RESULTS: For multivariate analysis, age, race/ethnicity, type of insurance, and type of hospital were significantly associated with the use of reconstruction for DCIS patients. DCIS patients were twice as likely to undergo reconstruction as patients with invasive cancer (odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.75-2.13). DCIS patients with private insurance were nine times more likely to undergo reconstruction as patients with Medicaid (OR = 8.84, 95% CI = 5.92-13.21). Both Hispanic white and Asian patients were one-fifth as likely to undergo reconstruction compared with non-Hispanic white patients (OR = 0.18, 95% CI = 0.1-0.3; OR = 0.17, 95% CI = 0.09-0.31). CONCLUSIONS: Postmastectomy rates for DCIS were twice those for invasive cancer mostly because stage was not a limiting factor. However, significant factors remain that limit the use of reconstruction in this breast cancer population: age, race/ethnicity, type of hospital, and type of insurance.
BACKGROUND: Many factors influence whether breast cancerpatients undergo reconstruction after mastectomy. This study was undertaken to determine the patterns of care and variables associated with the use of reconstruction for ductal carcinoma in situ (DCIS) and to compare previous results for invasive carcinoma. METHODS: Postmastectomy reconstruction rates were collected from the California Office of Statewide Health Planning and Development (OSHPD) for 2003-2007. International Classification of Disease-9 codes were used to identify patients undergoing reconstruction after mastectomy. Variations in reconstruction rates were examined by type of breast cancer (DCIS vs. invasive), calendar year, age, type of insurance, type of hospital, and race/ethnicity. Univariate and multivariate odds ratios (OR) with 95% confidence intervals (CI) were estimated for relative odds of immediate reconstruction versus mastectomy only. RESULTS: For multivariate analysis, age, race/ethnicity, type of insurance, and type of hospital were significantly associated with the use of reconstruction for DCIS patients. DCIS patients were twice as likely to undergo reconstruction as patients with invasive cancer (odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.75-2.13). DCIS patients with private insurance were nine times more likely to undergo reconstruction as patients with Medicaid (OR = 8.84, 95% CI = 5.92-13.21). Both Hispanic white and Asian patients were one-fifth as likely to undergo reconstruction compared with non-Hispanic white patients (OR = 0.18, 95% CI = 0.1-0.3; OR = 0.17, 95% CI = 0.09-0.31). CONCLUSIONS: Postmastectomy rates for DCIS were twice those for invasive cancer mostly because stage was not a limiting factor. However, significant factors remain that limit the use of reconstruction in this breast cancer population: age, race/ethnicity, type of hospital, and type of insurance.
Authors: Oyewale O Shiyanbola; Brian L Sprague; John M Hampton; Kim Dittus; Ted A James; Sally Herschorn; Ronald E Gangnon; Donald L Weaver; Amy Trentham-Dietz Journal: Cancer Date: 2016-05-31 Impact factor: 6.860
Authors: Adeyiza O Momoh; Kent A Griffith; Sarah T Hawley; Monica Morrow; Kevin C Ward; Ann S Hamilton; Dean Shumway; Steven J Katz; Reshma Jagsi Journal: Plast Reconstr Surg Date: 2019-08 Impact factor: 4.730
Authors: Jason D Wright; Ling Chen; Melissa Accordino; Bret Taback; Cande V Ananth; Alfred I Neugut; Dawn L Hershman Journal: Ann Surg Oncol Date: 2018-10-16 Impact factor: 5.344
Authors: Chandler S Cortina; Carmen R Bergom; Julie Kijack; Abigail A Thorgerson; Chiang-Ching Spencer Huang; Amanda L Kong Journal: Surgery Date: 2021-04-20 Impact factor: 4.348