scholarly journals A Qualitative Assessment of the Journey to Delayed Breast Reconstruction

2017 ◽  
Vol 25 (3) ◽  
pp. 157-162 ◽  
Author(s):  
Ho Man Cheng ◽  
Catherine McMillan ◽  
Joan E. Lipa ◽  
Laura Snell
Keyword(s):  
Breast Reconstruction ◽  
Plastic Surgery ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Tertiary Care ◽  
The United States ◽  
Immediate Breast Reconstruction ◽  
Qualitative Assessment ◽  
Tertiary Care Centre ◽  
Delayed Breast Reconstruction

Background: Canada has low immediate breast reconstruction (IBR) rates compared to the United States and Europe. Breast cancer survivors live with mastectomy defects sometimes for years, and this represents an area for improvement in cancer care. Purpose: This study qualitatively assessed (1) information provided about breast reconstruction at the time of cancer diagnosis among women seeking delayed breast reconstruction (DBR) and (2) referral practices for plastic surgery consultation for DBR. Methods: Fifty-two consecutive patients seen in consultation for DBR at a single Canadian tertiary care centre completed questionnaires regarding their experience in seeking breast reconstruction. Seven semi-structured interviews were conducted to further explore themes identified through questionnaires. Questionnaire responses and interview transcripts were analyzed for recurring themes using standard qualitative techniques. Results: A significant portion of women (43%) was interested in reconstruction prior to mastectomy, yet IBR was infrequently discussed (14%) or discouraged by their oncologic surgeons (33%). Common patient reasons for not pursuing IBR were referring physician objection and not having adequate knowledge. Women expressed wanting to discuss reconstruction at the time of cancer diagnosis. Half of the patients had attended another consultation, but the initial plastic surgeon either did not offer procedures for which these women were candidates or had prohibitively long surgical wait times. Conclusion: Lack of information about reconstructive options at the time of cancer diagnosis and perceived access barriers to plastic surgeons may contribute to underutilization of IBR in Canada. Access to breast reconstruction can be improved by reducing inefficiencies in plastic surgery referrals.

Immediate Breast Reconstruction in The Netherlands and the United States

2019 ◽  
Vol 144 (4) ◽  
pp. 565e-574e
Author(s):  
Parisa Kamali ◽  
Annelotte van Bommel ◽  
Babette Becherer ◽  
Rodney Cooter ◽  
Marc A. M. Mureau ◽  
...  
Keyword(s):  
United States ◽  
The Netherlands ◽  
Breast Reconstruction ◽  
The United States ◽  
Immediate Breast Reconstruction

Does Immediate Tissue Expander Placement Increase Immediate Postoperative Complications in Patients with Breast Cancer?

2015 ◽  
Vol 81 (2) ◽  
pp. 143-149
Author(s):  
Hossein Masoomi ◽  
Keyianoosh Z. Paydar ◽  
Gregory R. D. Evans ◽  
Emily Tan ◽  
Karen T. Lane ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Hospital Mortality ◽  
Breast Reconstruction ◽  
Complication Rate ◽  
Tissue Expander ◽  
The United States ◽  
Immediate Breast Reconstruction ◽  
Perioperative Outcomes ◽  
Immediate Reconstruction

The objectives of this study were to evaluate 1) the rate of immediate breast reconstruction; 2) the frequency of immediate tissue expander placement; and 3) to compare perioperative outcomes in patients who underwent breast reconstruction after mastectomy for breast cancer with immediate tissue expander placement (TE) with those with no reconstruction (NR). Using the Nationwide Inpatient Sample database, we examined the clinical data of patients with breast cancer who underwent mastectomy with or without immediate TE from 2006 to 2010 in the United States. A total of 344,253 patients with breast cancer underwent mastectomy in this period in the United States. Of these patients, 31 per cent had immediate breast reconstruction. We only included patients with mastectomy and no reconstruction (NR: 237,825 patients) and patients who underwent only TE placement with no other reconstruction combination (TE: 61,178 patients) to this study. Patients in the TE group had a lower overall postoperative complication rate (2.6 vs 5.5%; P < 0.01) and lower in-hospital mortality rate (0.01 vs 0.09%; P < 0.01) compared with the NR group. Fifty-three per cent of patients in the NR group were discharged the day of surgery compared with 36 per cent of patients in the TE group. Using multivariate regression analyses and adjusting patient characteristics and comorbidities, patients in the TE group had a significantly lower overall complication rate (adjusted odds ratio [AOR], 0.6) and lower in-hospital mortality (AOR, 0.2) compared with the NR group. The rate of immediate reconstruction is 31 per cent. TE alone is the most common type of immediate reconstruction (57%). There is a lower complication rate for the patients who underwent immediate TE versus the no-reconstruction cohort.

Changes in Psychosocial Functioning 1 Year After Mastectomy Alone, Delayed Breast Reconstruction, or Immediate Breast Reconstruction

2011 ◽  
Vol 19 (1) ◽  
pp. 233-241 ◽  
Author(s):  
Kelly A. Metcalfe ◽  
John Semple ◽  
May-Lynn Quan ◽  
Susan T. Vadaparampil ◽  
Claire Holloway ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Psychosocial Functioning ◽  
Immediate Breast Reconstruction ◽  
Delayed Breast Reconstruction

Disparities in Rural Breast Cancer Care: Factors Affecting Choice of Breast Reconstruction in a West Virginia Tertiary Care Hospital

2017 ◽  
Vol 83 (7) ◽  
pp. 717-721 ◽  
Author(s):  
Tyler L. Holliday ◽  
Patrick D. Suggs ◽  
Stephanie N. Thompson ◽  
Bryan K. Richmond
Keyword(s):  
Breast Cancer ◽  
West Virginia ◽  
Breast Reconstruction ◽  
Rural Population ◽  
Early Stage ◽  
Tertiary Care ◽  
The United States ◽  
Care Hospital ◽  
Unilateral Breast Cancer ◽  
Insurance Type

The decision to pursue immediate postmastectomy breast reconstruction (IBR) is not uniform across all groups of women in the United States. We sought to investigate if the challenges of caring for a socioeconomically and geographically challenged rural population affected the incidence of IBR and to identify predictive factors of IBR in this population. Using our institution's cancer registry, we conducted a 10-year review of women with early-stage, unilateral breast cancer who received mastectomy. Demographics, insurance status, comorbidities, and surgeon graduation year were compared for patients receiving IBR versus no reconstruction. Variables with P < 0.05 on univariate analysis were included into a multivariate logistic regression model to determine independent predictors of IBR. From 2006 to 2015, 53/423 (12.5%) patients underwent IBR. On multivariate analysis, three factors independently predicted the decision to undergo IBR: age (P = 0.004), insurance type (P = 0.034), and use of contralateral prophylactic mastectomy (CPM, P < 0.001). Our data indicate that age, insurance type, and utilization of CPM influence the decision to pursue reconstruction. Additionally, the rate of IBR was found to be much lower in our West Virginia population than reported nationally, suggesting disparities in the care of women with early-stage, unilateral breast cancer in a rural population, even in a tertiary care environment.

Treatment Options for Bilateral Autologous Breast Reconstruction in Patients with Inadequate Donor-Site Volume

2017 ◽  
Vol 33 (05) ◽  
pp. 305-311 ◽  
Author(s):  
Michael Chu ◽  
Fares Samra ◽  
Suhail Kanchwala ◽  
Arash Momeni
Keyword(s):  
Breast Reconstruction ◽  
Lower Cost ◽  
Treatment Options ◽  
Donor Site ◽  
The United States ◽  
Immediate Breast Reconstruction ◽  
Autologous Reconstruction ◽  
Microsurgical Reconstruction ◽  
Tissue Reconstruction

AbstractMore than 250,000 women will be diagnosed with invasive breast cancer in the United States in 2017 alone. A large number of these patients will undergo mastectomy and will be candidates for immediate breast reconstruction. The most common reconstructive options are either implant-based or autologous tissue reconstruction, with the latter having been reported to have higher rates of long-term patient satisfaction, lower cost, and less postoperative pain. A subset of patients, however, may not be ideal candidates for autologous microsurgical reconstruction, for example, due to inadequate abdominal tissues, yet they may desire this reconstructive modality. This is particularly challenging in patients requiring bilateral reconstructions. In this article, the authors discuss the various reconstructive modalities that can be considered in patients who desire bilateral breast reconstruction, are not ideal candidates for autologous reconstruction, yet do not wish to rely solely on implant-based modalities.

scholarly journals 2122

2017 ◽  
Vol 1 (S1) ◽  
pp. 24-24
Author(s):  
Lisa M. Shandley ◽  
Lauren M. Daniels ◽  
Jessica B. Spencer ◽  
Ann C. Mertens ◽  
Penelope P. Howards
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Unintended Pregnancy ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
The United States ◽  
Population Based ◽  
Reproductive Age ◽  
Bilateral Oophorectomy ◽  
After Cancer

OBJECTIVES/SPECIFIC AIMS: In the United States, it is estimated that approximately half of all pregnancies are unintended. This study examines the prevalence of unintended pregnancy in a cohort of cancer survivors and identifies factors associated with unintended pregnancy after cancer. METHODS/STUDY POPULATION: The FUCHSIA Women’s Study is a population-based study of female cancer survivors at a reproductive age of 22–45 years. Cancer survivors diagnosed between the ages of 20 and 35 years and at least 2 years postdiagnosis were recruited in collaboration with the Georgia Cancer Registry. Participants were interviewed about their reproductive histories. The prediagnosis analysis included all women who completed the interview; the postdiagnosis analysis excluded those who had a hysterectomy, bilateral oophorectomy, or tubal ligation by cancer diagnosis. RESULTS/ANTICIPATED RESULTS: Of the 1282 survivors interviewed, 57.5% reported at least 1 pregnancy before cancer diagnosis; of which, 44.5% were unintended. Of the 1088 survivors included in the postdiagnosis analysis, 36.9% reported a post-cancer pregnancy. Among those who had a pregnancy after cancer diagnosis, 38.6% reported at least 1 pregnancy was unintended. Of the 80 breast cancer survivors who had a pregnancy after diagnosis, 52.5% of them were unintended. Predictors of unintended pregnancy in cancer survivors included being younger than 30 years at diagnosis [odds ratio (OR) 2.1; 95% confidence interval (CI) 1.4, 2.9], identifying as Black (OR 1.6, 95% CI 1.1, 2.3, comparison: White), and having resumption of menses after cancer treatment (OR 8.1, 95% CI 2.0, 33.0). Compared with being <4 years from cancer diagnosis, those who were farther from diagnosis at the time of the interview also had increased odds of unintended pregnancy (4–7 years: OR 1.5, 95% CI 0.9, 2.7; 8–10 years: OR 1.3, 95% CI 0.7, 2.4; >10 years: OR 2.7, 95% CI 1.6, 4.7). DISCUSSION/SIGNIFICANCE OF IMPACT: Despite being at higher risk of infertility, cancer survivors may still be at considerable risk of unintended pregnancy. Women with certain types of cancer that are more likely to be hormone responsive, such as some types of breast cancer, may be hesitant to use hormonal birth control and thus be at higher risk of unintended pregnancy. Counseling for cancer survivors should include a discussion of the risk of unintended pregnancy and contraceptive options.

scholarly journals Immediate breast reconstruction for women having inflammatory breast cancer in the United States

2018 ◽  
Vol 7 (7) ◽  
pp. 2887-2902 ◽  
Author(s):  
Sameer A. Patel ◽  
Marilyn Ng ◽  
Salvatore M. Nardello ◽  
Karen Ruth ◽  
Richard J. Bleicher
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Breast Reconstruction ◽  
Inflammatory Breast Cancer ◽  
The United States ◽  
Immediate Breast Reconstruction
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