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Perceived Financial Decline Related to Breast Reconstruction Following Mastectomy in a Diverse Population-Based Cohort
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3 15 2022
Source: Cancer. 128(6):1284-1293 -
Alternative Title:Cancer
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Personal Author:
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Description:Background:
Despite mandated insurance coverage for breast reconstruction following mastectomy, health care costs are increasingly passed on to women through cost-sharing arrangements and high-deductible health plans. In this population-based study, we assessed perceived financial and employment decline related to breast reconstruction following mastectomy.
Methods:
Women with early-stage breast cancer (stages 0-II) diagnosed between July 2013 to May 2015 who underwent mastectomy were identified through the Georgia and Los Angeles Surveillance, Epidemiology, and End Results (SEER) registries and surveyed. Primary outcome measures included patient appraisal of financial and employment status following cancer treatment. Multivariable models evaluated the association between breast reconstruction and primary outcomes.
Results:
Among 883 breast cancer patients who underwent mastectomy, 44.2% did not undergo breast reconstruction and 55.8% underwent reconstruction. Overall, 21.9% of the cohort reported being worse off financially since their diagnosis (25.8% with vs. 16.6% without reconstruction, P=.002). Women who underwent reconstruction reported higher out-of-pocket medical expenses (32.1% vs. 15.6% with expenses greater than $5,000, P<.001). Reconstruction was independently associated with perceived decline in financial status (Odds Ratio (OR) 1.92, 95% Confidence Interval (CI) 1.15–3.22, P=.013). Among women who were employed at time of diagnosis, there was no association between reconstruction and perceived decline in employment status (P=.927).
Conclusions:
In this diverse cohort of women who underwent mastectomy, those who elected to undergo reconstruction experienced higher out-of-pocket medical expenses and self-reported financial decline. Patients, providers, and policy makers should be aware of the potential financial implications related to reconstruction despite mandatory insurance coverage.
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Pubmed ID:34847259
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Pubmed Central ID:PMC8882150
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