Postmastectomy Breast Reconstruction Patterns at an Urban Academic Hospital and the Impact of Surgeon Gender

Autor: Genevieve, Fasano, Solange, Bayard, Rulla, Tamimi, Anjile, An, Michael E, Zenilman, Melissa, Davis, Lisa, Newman, Vivian J, Bea
Rok vydání: 2022
Předmět:
Zdroj: Annals of Surgical Oncology. 29:5437-5444
ISSN: 1534-4681
1068-9265
Popis: Postmastectomy breast reconstruction is an essential element of multidisciplinary breast cancer care but may be underutilized.This retrospective study analyzed mastectomy patients (2018-2021) at an urban hospital. Multivariable logistic regression was performed, and a mixed-effects logistic regression model was constructed to determine patient-level factors (age, race, body mass index, comorbidities, smoking status, insurance, type of surgery) and provider-level factors (breast surgeon gender, participation in multidisciplinary breast clinic) that influence reconstruction.Overall, 167 patients underwent mastectomy. The reconstruction rate was 35%. In multivariable analysis, increasing age (odds ratio [OR] 0.95; 95% confidence interval [CI] 0.91-0.99) and Medicaid insurance (OR 0.18; 95% CI 0.06-0.53) relative to private insurance were negative predictors, whereas bilateral mastectomy was a positive predictor (OR 7.07; 95% CI 2.95-17.9) of reconstruction. After adjustment for patent age, race, insurance, and type of surgery, female breast surgeons had 3.7 times greater odds of operating on patients who had reconstruction than males (95% CI 1.20-11.42).Both patient- and provider-level factors have an impact on postmastectomy reconstruction. Female breast surgeons had nearly four times the odds of caring for patients who underwent reconstruction, suggesting that a more standardized process for plastic surgery referral is needed.
Databáze: OpenAIRE
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