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National Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy.

Publication ,  Journal Article
Razdan, SN; Cordeiro, PG; Albornoz, CR; Disa, JJ; Panchal, HJ; Ho, AY; Momoh, AO; Matros, E
Published in: J Reconstr Microsurg
June 2017

Background Immediate breast reconstruction (IBR) is often deferred, when postmastectomy radiotherapy (PMRT) is anticipated, due to high complication rates. Nonetheless, because of robust data supporting improved health-related quality of life associated with reconstruction, physicians and patients may be more accepting of tradeoffs. The current study explores national trends of IBR utilization rates and methods in the setting of PMRT, using the National Cancer Database (NCDB). The study hypothesis is that prosthetic techniques have become the most common method of IBR in the setting of PMRT. Methods NCDB was queried from 2004 to 2013 for women, who underwent mastectomy with or without IBR. Patients were grouped according to PMRT status. Multivariate logistic regression was used to calculate odds of IBR in the setting of PMRT. Trend analyses were done for rates and methods of IBR using Poisson regression to determine incidence rate ratios (IRRs). Results In multivariate analysis, radiated patients were 30% less likely to receive IBR (p < 0.05). The rate increase in IBR was greater in radiated compared with nonradiated patients (IRR: 1.12 vs. 1.09). Rates of reconstruction increased more so in radiated compared with nonradiated patients for both implants (IRR 1.15 vs. 1.11) and autologous techniques (IRR 1.08 vs. 1.06). Autologous reconstructions were more common in those receiving PMRT until 2005 (p < 0.05), with no predominant technique thereafter. Conclusion Although IBR remains a relative contraindication, rates of IBR are increasing to a greater extent in patients receiving PMRT. Implants have surpassed autologous techniques as the most commonly used method of breast reconstruction in this setting.

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Published In

J Reconstr Microsurg

DOI

EISSN

1098-8947

Publication Date

June 2017

Volume

33

Issue

5

Start / End Page

312 / 317

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Surgery
  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Quality of Life
  • Practice Patterns, Physicians'
  • Mastectomy
  • Mammaplasty
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Razdan, S. N., Cordeiro, P. G., Albornoz, C. R., Disa, J. J., Panchal, H. J., Ho, A. Y., … Matros, E. (2017). National Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy. J Reconstr Microsurg, 33(5), 312–317. https://doi.org/10.1055/s-0037-1598201
Razdan, Shantanu N., Peter G. Cordeiro, Claudia R. Albornoz, Joseph J. Disa, Hina J. Panchal, Alice Y. Ho, Adeyiza O. Momoh, and Evan Matros. “National Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy.J Reconstr Microsurg 33, no. 5 (June 2017): 312–17. https://doi.org/10.1055/s-0037-1598201.
Razdan SN, Cordeiro PG, Albornoz CR, Disa JJ, Panchal HJ, Ho AY, et al. National Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy. J Reconstr Microsurg. 2017 Jun;33(5):312–7.
Razdan, Shantanu N., et al. “National Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy.J Reconstr Microsurg, vol. 33, no. 5, June 2017, pp. 312–17. Pubmed, doi:10.1055/s-0037-1598201.
Razdan SN, Cordeiro PG, Albornoz CR, Disa JJ, Panchal HJ, Ho AY, Momoh AO, Matros E. National Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy. J Reconstr Microsurg. 2017 Jun;33(5):312–317.
Journal cover image

Published In

J Reconstr Microsurg

DOI

EISSN

1098-8947

Publication Date

June 2017

Volume

33

Issue

5

Start / End Page

312 / 317

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Surgery
  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Quality of Life
  • Practice Patterns, Physicians'
  • Mastectomy
  • Mammaplasty