Higher increase in rates over time seen for Black and Asian patients versus White patients and for Medicaid, Medicare patients
By Elana Gotkine HealthDay Reporter
FRIDAY, Dec. 13, 2024 (HealthDay News) — Breast reconstruction (BR) rates increased from 2005 to 2012, then stabilized from 2013 to 2017, according to a study published online in the December issue of Plastic and Reconstructive Surgery.
Robyn N. Rubenstein, M.D., from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues examined longitudinal trends in BR rates in the United States using data for mastectomy cases with and without BR from 2005 through 2017 abstracted from the National Surgical Quality Improvement Program database; the Surveillance, Epidemiology, and End Results Program database; and the National Cancer Database (NCDB). Predictors of reconstruction were identified, and race and insurance distributions were assessed over time.
The researchers found that 32.7 percent of 1,554,381 mastectomy patients underwent BR. From 2005 to 2012, there was an increase in the annual reconstruction rates per 1,000 mastectomies (incidence rate ratios, 1.077 for the National Surgical Quality Improvement Program; 1.090 for the Surveillance, Epidemiology, and End Results Program; and 1.092 for the NCDB); from 2013 to 2017, rates stabilized. The likelihood of undergoing BR was increased for patients who were younger (aged ≤59 years), privately insured, with fewer comorbidities, and who underwent contralateral prophylactic mastectomy. The increase in BR rates was higher among Black and Asian patients than White patients over time (252.3, 366.4, and 137.3 percent, respectively). BR rates increased more among Medicaid and Medicare patients compared with privately insured patients (418.6, 302.8, and 125.3 percent, respectively).
“We have demonstrated a stabilization in breast reconstruction rates over the past decade despite legislation to increase public awareness of access to breast reconstruction,” the authors write. “Simultaneously, we observed a reduction in some historical health care disparities, including race and insurance type.”
Several authors disclosed ties to the pharmaceutical and medical device industries.
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