An analysis of immediate postmastectomy breast reconstruction frequency using the surveillance, epidemiology, and end results database

Shailesh Agarwal, Lisa Pappas, Leigh A Neumayer, Jayant Agarwal

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Mastectomy is used to treat one third of the nearly 180,000 women diagnosed with breast cancer in the United States annually. In this study, we use population-level data from multiple years of the Surveillance, Epidemiology, End Results (SEER) database to further define patient, tumor, and geographic characteristics associated with immediate and early-delayed breast reconstruction. Population level de-identified data for the years 1998 to 2002 were extracted from the National Cancer Institute's (NCI) SEER cancer database. All female patients who were treated with mastectomy for a diagnosis of ductal and/or lobular breast cancer (including Paget disease) were included. The primary end point of interest was odds of reconstruction. Multivariate analysis was performed to control for patient demographic and oncologic characteristics. A total of 52,249 patients met the inclusion criteria. Reconstruction was performed in 8,446 patients (16.2%). Odds of reconstruction varied by region from 0.60 (Seattle) to 2.81 (Atlanta). African Americans were noted to have a significantly lower likelihood of reconstruction when compared with Caucasian patients (OR 0.60 versus 1.00). Patients living in nonmetropolitan regions were also significantly less likely to undergo reconstruction. Receipt of radiation therapy was also negatively correlated with likelihood of reconstruction. In this multicenter, multiyear analysis of factors associated with immediate or early-delayed reconstruction after mastectomy, we demonstrate that younger age, white race, metropolitan locale, and lower stage disease were all independently associated with higher likelihood of reconstruction. This information provides insight into breast reconstruction utilization and will help guide future studies to understand how these factors affect patient and physician decision-making.

Original languageEnglish (US)
Pages (from-to)352-358
Number of pages7
JournalBreast Journal
Volume17
Issue number4
DOIs
StatePublished - Jul 2011
Externally publishedYes

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Mammaplasty
Epidemiology
Databases
Mastectomy
Breast Neoplasms
National Cancer Institute (U.S.)
African Americans
Population
Statistical Factor Analysis
Neoplasms
Decision Making
Radiotherapy
Multivariate Analysis
Demography
Physicians

Keywords

  • breast cancer
  • immediate breast reconstruction
  • multivariate analysis

ASJC Scopus subject areas

  • Internal Medicine
  • Oncology
  • Surgery

Cite this

An analysis of immediate postmastectomy breast reconstruction frequency using the surveillance, epidemiology, and end results database. / Agarwal, Shailesh; Pappas, Lisa; Neumayer, Leigh A; Agarwal, Jayant.

In: Breast Journal, Vol. 17, No. 4, 07.2011, p. 352-358.

Research output: Contribution to journalArticle

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