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Women less likely to undergo immediate breast reconstruction at safety net hospitals

Women undergoing mastectomies at safety net hospitals were significantly less likely to undergo immediate breast reconstruction than women at non-safety net hospitals, according to recent findings.

The researchers conducted a retrospective cross-sectional review of the Nationwide Inpatient Sample database to identify women aged 21 years or older with a diagnosis of breast cancer or indications of elevated breast cancer risk. Data from 2005 through 2011 underwent analysis.

The current data set includes information for 105,677 registered mastectomies.

Hospitals with the highest tertile of Medicaid disproportionate share hospital patient adjustments were determined to be safety net hospitals.

The rate of immediate reconstructions at safety net hospitals was 31%, compared with 46% at non-safety net hospitals (P < .001).

Multivariable analysis results indicated that women being treated at non-safety net hospitals had a significantly higher likelihood of undergoing reconstruction (OR = 1.89; 95% CI, 1.65-2.16).

Other findings showed, however, that reconstruction rates at safety net hospitals improved over time. Overall, women undergoing mastectomies in 2011 were significantly more likely to undergo immediate reconstruction than their counterparts in 2005 (OR = 2.31; 95% CI, 2.12-2.52). This trend was similar in safety net hospitals, with women in 2011 more than twice as likely to undergo reconstruction at those centers than women in 2005 (OR = 2.31; 95% CI, 2.13-2.52).

“The availability of immediate reconstruction lessens the psychological

trauma of mastectomy, and it is critical to continue redirecting federal efforts

toward this valuable component of breast cancer care,” the researchers concluded.  – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.