SABCS: Post-Mastectomy Reconstruction Factors ID'd

Reconstruction rates higher with commercial insurance, those younger than 50 years

THURSDAY, Dec. 8 (HealthDay News) -- A minority of women with breast cancer undergo breast reconstruction after mastectomy, with higher rates seen in younger women (below 50 years) and those with commercial insurance, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.

Dawn L. Hershman, M.D., from Columbia University in New York City, and colleagues investigated the association of demographic, hospital, physician, and insurance factors with immediate breast reconstruction, among 106,988 women with breast cancer who underwent mastectomy between 2000 and 2010. Differences in reconstruction rates over time were identified on the basis of age, race, and insurance type. The population of women younger than 50 years of age were analyzed separately.

The investigators found that 22.6 percent of the cohort underwent reconstruction. The reconstruction rate increased from 15 percent in 2000 to 33 percent in 2010. The largest increases were seen for women with commercial insurance (from 25.3 to 54.6 percent) and those younger than 50 years (from 29 to 60 percent); women younger than 50 years with commercial insurance had a reconstruction rate of 67.5 percent in 2010. On multivariable analysis, the likelihood of reconstruction was significantly less with increasing age, black race, the presence of more than two comorbid conditions, rural hospital location, or a non-teaching hospital. Commercial and public insurance (compared to self-pay), bilateral mastectomies, being single, and increased hospital volume correlated with increased odds of reconstruction.

"Insurance status was one of the largest predictors of immediate reconstruction," the authors write.

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