Surgical Outcomes ResearchA sociodemographic and economic comparison of breast reconstruction, mastectomy, and conservative surgery☆
Section snippets
Data sources
Data for this study were obtained from the Virginia Cancer Registry (VCR) and Trigon Blue Cross Blue Shield of Virginia (Trigon). During the study period (1989 to 1993), the registry collected data from approximately 50 hospitals, representing about 85% of the hospital beds in the state. Over this period Trigon insured approximately 30% of the state population; the penetration by managed care was low at that time. Cancer registry data were collected prospectively by trained registrars with use
Clinical factors
Table 1 shows the demographic and clinical characteristics of the women with breast cancer and the 3 treatment options studied in this report.
Characteristics Breast cancer cohort (No. [%]) (n = 592) Lumpectomy + radiation No. [%]) (n = 156) Mastectomy (No. [%]) (n = 341) Mastectomy + reconstruction (No. [%]) (n = 95) Age (y) <51 264 (45) 75 (48) 129 (38) 60 (63) 51-64 328 (55) 81 (52) 212 (62) 35 (37) Race White 491 (83) 132 (85) 275 (81) 84 (88) Black 101 (17) 24 (15)
Discussion
Breast reconstruction has been used for many years to treat the cosmetic defect of a modified radical mastectomy. Prosthetic implantation and flap procedures provide good cosmetic results and patient satisfaction.13, 22 However, less is known about what factors determine which women will undergo reconstruction.
From 1989 to 1991 only 26% of women less than 64 years old had BCS. However, the rate of BCS in this age group was comparable to that of other urban areas in the United States with large
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Reprint requests: Christopher E. Desch, MD, Massey Cancer Center, Box 980037, Richmond, VA 23298-0037.