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Patterns and Correlates of Knowledge, Communication, and Receipt of Breast Reconstruction in a Modern Population-Based Cohort of Patients with Breast Cancer
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8-2019
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Source: Plast Reconstr Surg. 144(2):303-313
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Details:
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Alternative Title:Plast Reconstr Surg
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Personal Author:
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Description:Background:
Disparities persist in the receipt of breast reconstruction after mastectomy and little is known about the nature of communication received by patients and potential variations that may exist.
Methods:
Women with early stage breast cancer (stages 0-II) diagnosed between July 2013 and September 2014 were identified through the Georgia and Los Angeles SEER registries and surveyed to collect additional data on demographics, treatment and decision-making experiences. Treating general/oncologic surgeons were also surveyed. Primary outcomes measures included self-reported communication-related measures on receipt of information on breast reconstruction and on the receipt of breast reconstruction.
Results:
We analyzed 936 women who underwent mastectomy for unilateral breast cancer. 484 (51.7%) underwent mastectomy with reconstruction. Women who were older and for whom English was not their primary spoken language had lower odds of being informed by a doctor about breast reconstruction. Ultimately, women who were older, were Asian, had invasive disease, had bronchitis/emphysema, and had lower income were less likely to undergo breast reconstruction. Breast reconstruction was performed more often in patients undergoing bilateral mastectomies (OR, 3.27; 95% CI, 2.26–4.75). Women cared for by surgeons with higher volumes of breast cancer patients (51+ patients per year) were more likely to undergo breast reconstruction (OR 2.43, 95% CI 1.40–4.20).
Conclusions:
To eliminate existing disparities, increased efforts should be made in consultations for surgical management of breast cancer to provide information to all patients regarding the option of breast reconstruction, the possibility of immediate reconstruction, and insurance coverage of all stages of reconstruction.
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Pubmed ID:31348333
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Pubmed Central ID:PMC6662624
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