Trends in immediate breast reconstruction and radiation after mastectomy: A population study Article Swipe
Christopher Doherty
,
Sabrina Pearce
,
Nancy N. Baxter
,
Sarah Knowles
,
Douglas C. Ross
,
J. Andrew McClure
,
Muriel Brackstone
·
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1111/tbj.13500
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1111/tbj.13500
In the last decade, there has been an increase in women undergoing immediate breast reconstruction (IBR) at the time of mastectomy. Recent literature suggests a shift in practice: Surgeons are becoming more comfortable with IBR in the setting of possible postoperative adjuvant radiotherapy, despite the known complications. This study sought to investigate, at a population level, the patient and surgeon characteristics associated with the use of IBR and which of these factors were predictive of adjuvant radiotherapy. This retrospective population-based cohort study included all adult women who underwent mastectomy in the province of Ontario from 2007 to 2014. The Canadian Institute for Health Information (CIHI) administrative data base was used to generate patient demographic and clinical data. The Ontario Health Insurance Plan (OHIP) data base was used to elicit surgeon characteristics including clinical experience and volume of practice dedicated to breast surgery. Outcome variables included reconstruction concurrent with mastectomy, alloplastic vs autologous reconstruction, and use of radiation. A total of 25 861 patients underwent mastectomy and 2972 had IBR (11.5%). The rate of IBR after mastectomy increased over time from 7.2% in 2007 to 17.2% in 2014 (P < .001). There was also an increase in the proportion of patients with IBR who received radiation over the time period, from 19.4% in 2007 to 28.2% in 2014 (P = .003). In the first regression analysis, IBR was associated with younger patient age, residing in closer proximity to cancer clinics, absence of malignant breast disease (ie, prophylactic mastectomy), having a younger surgeon performing the mastectomy, and receiving care at a teaching hospital. A second analysis showed that patient variables predictive of radiation after IBR were a younger age and a more advanced cancer stage and no variables specific to surgeon or institution were predictive of radiation in patients with IBR. A significant increase in the rate of IBR as well as the use of radiation occurred over the 7-year study period. Multiple patient and surgeon factors were associated with IBR. Variables associated with radiation in IBR were harder to predict. Given the increase in the use of radiation in IBR, further research is needed to look at long-term outcomes in these patients at the population level.
Related Topics
Concepts
Medicine
Mastectomy
Breast reconstruction
Breast cancer
Radiation therapy
Population
Cohort
Retrospective cohort study
Surgery
General surgery
Cancer
Internal medicine
Environmental health
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1111/tbj.13500
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/tbj.13500
- OA Status
- bronze
- Cited By
- 43
- References
- 36
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2973347997
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2973347997Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1111/tbj.13500Digital Object Identifier
- Title
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Trends in immediate breast reconstruction and radiation after mastectomy: A population studyWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2019Year of publication
- Publication date
-
2019-09-18Full publication date if available
- Authors
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Christopher Doherty, Sabrina Pearce, Nancy N. Baxter, Sarah Knowles, Douglas C. Ross, J. Andrew McClure, Muriel BrackstoneList of authors in order
- Landing page
-
https://doi.org/10.1111/tbj.13500Publisher landing page
- PDF URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/tbj.13500Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
- OA URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/tbj.13500Direct OA link when available
- Concepts
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Medicine, Mastectomy, Breast reconstruction, Breast cancer, Radiation therapy, Population, Cohort, Retrospective cohort study, Surgery, General surgery, Cancer, Internal medicine, Environmental healthTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
43Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 14, 2023: 4, 2022: 11, 2021: 7Per-year citation counts (last 5 years)
- References (count)
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36Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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