Predictors of delayed breast reconstruction in the Netherlands: a 5-year follow-up study in stage I-III breast cancer patients.

Autor: van Egdom LSE; Department of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands. l.vanegdom@erasmusmc.nl.; Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center, P.O. 2040, 3000 CA, Rotterdam, the Netherlands. l.vanegdom@erasmusmc.nl., de Ligt KM; Department of Psychosocial Research, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands., de Munck L; Department of Research and Development, Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands., Koppert LB; Department of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands., Mureau MAM; Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center, P.O. 2040, 3000 CA, Rotterdam, the Netherlands., Rakhorst HA; Department of Plastic and Reconstructive Surgery, Medisch Spectrum Twente, Enschede, The Netherlands., Siesling S; Department of Research and Development, Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
Jazyk: angličtina
Zdroj: Breast cancer (Tokyo, Japan) [Breast Cancer] 2022 Mar; Vol. 29 (2), pp. 324-335. Date of Electronic Publication: 2021 Nov 15.
DOI: 10.1007/s12282-021-01313-1
Abstrakt: Purpose: Delayed breast reconstruction (DBR) is a valid option for postmastectomy breast cancer patients who have a desire for breast reconstruction but are not considered suitable for immediate breast reconstruction (IBR). The objective of this study was to investigate the clinical practice and predictors of the use of DBR in the Netherlands.
Methods: Stage I-III breast cancer patients diagnosed from January to March 2012 and treated with mastectomy were selected from the Netherlands Cancer Registry. Routinely collected patient, tumor, treatment and hospital characteristics were complemented with data about DBR up to 2018. Multivariable logistic regression analyses were performed to identify factors independently associated with postmastectomy DBR. Factors associated with time to DBR were identified through Cox regression analyses.
Results: Of all patients who underwent mastectomy (n = 1,415), 10.2% underwent DBR. DBR patients more often received autologous reconstruction compared to IBR patients (37.5% vs 6.2%, p < 0.001). Age below 50 years (age < 35 OR 15.55, age 35-49 OR 4.18) and neoadjuvant and adjuvant chemotherapy (OR 2.59 and OR 2.83, respectively) were significantly associated with DBR. Mean time to DBR was 2.4 years [range 1-6 years]. Time to DBR was significantly associated with age < 35 years (HR 2.22), and a high hospital volume (HR 1.87).
Discussion: The use of DBR after mastectomy could not be fully explained by age below 50 years, chemotherapy, and hospital volume. Treatment with radiotherapy and adjuvant chemotherapy increased time to DBR. More information about patient preferences is needed to understand the use and timing of reconstruction.
(© 2021. The Author(s).)
Databáze: MEDLINE
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