scholarly journals Objective decision making between conventional and oncoplastic breast-conserving surgery or mastectomy with immediate breast reconstruction

2017 ◽  
Author(s):  
Dávid Pukancsik
Keyword(s):  
Decision Making ◽  
Breast Reconstruction ◽  
Breast Conserving Surgery ◽  
Immediate Breast Reconstruction

Influencers of Immediate Post-Mastectomy Reconstruction: A National Cancer Database Analysis

2021 ◽  
Author(s):  
Dora Danko ◽  
Yuan Liu ◽  
Feifei Geng ◽  
Theresa W Gillespie
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Breast Reconstruction ◽  
Urban Areas ◽  
Private Insurance ◽  
Immediate Breast Reconstruction ◽  
Third Party ◽  
National Cancer Database ◽  
Immediate Reconstruction ◽  
The Impact

Abstract Background The literature examining decision-making related to treatment and reconstruction for women with breast cancer has established that patient, clinical, and facility factors all play a role. Objectives Using the National Cancer Database (NCDB), determine how patient, clinical, and facility factors influence: 1) the receipt of immediate breast reconstruction; and 2) the type of immediate breast reconstruction received (implant-based, autologous, or a combination). Methods A total of 638,772 female patients with TIS-T3, N0-N1, M0 breast cancers were identified in the NCDB from 2004-2017 who received immediate reconstruction following mastectomy. Univariate and multivariable logistic regression models were conducted to identify characteristics associated with immediate breast reconstruction and type of reconstruction. Results Immediate breast reconstruction was more frequently associated with patients of white race, younger age, with private insurance, with lesser comorbidities, who resided in zip-codes with higher median incomes or higher rate of high-school graduation, in urban areas, with Tis-T2 disease, or with <4 lymph node involvement (all odds ratios (OR) > 1.1). Negative predictors of immediate breast reconstruction were insurance status with Medicaid, Medicare, other government insurance, and none or unknown insurance (all ORs <0.79). Implant-based reconstruction was associated with non-black race, uninsured status, completion of higher education, undifferentiated disease, and stage T0 disease (all ORs >1.10). Conclusions These findings confirm some previous studies on what patient, clinical, and facility factors affect decision making, but also raise new questions that relate to the impact of third-party payor on receipt and type of reconstruction post-mastectomy for breast cancer.

scholarly journals The Changing Face of Mastectomy (from Mutilation to Aid to Breast Reconstruction)

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Stefano Zurrida ◽  
Fabio Bassi ◽  
Paolo Arnone ◽  
Stefano Martella ◽  
Andres Del Castillo ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Psychological Impact ◽  
Breast Conserving Surgery ◽  
Primary Treatment ◽  
Immediate Breast Reconstruction ◽  
The Past ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
New Skin

Breast cancer is the most common cancer in women. Primary treatment is surgery, with mastectomy as the main treatment for most of the twentieth century. However, over that time, the extent of the procedure varied, and less extensive mastectomies are employed today compared to those used in the past, as excessively mutilating procedures did not improve survival. Today, many women receive breast-conserving surgery, usually with radiotherapy to the residual breast, instead of mastectomy, as it has been shown to be as effective as mastectomy in early disease. The relatively new skin-sparing mastectomy, often with immediate breast reconstruction, improves aesthetic outcomes and is oncologically safe. Nipple-sparing mastectomy is newer and used increasingly, with better acceptance by patients, and again appears to be oncologically safe. Breast reconstruction is an important adjunct to mastectomy, as it has a positive psychological impact on the patient, contributing to improved quality of life.

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