Mastectomy with immediate Breast Reconstruction
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This study states that mastectomy with immediate reconstruction is increasingly performed in the United States. Several sociodemographic and hospital factors are associated with decreased utilization of immediate reconstruction. Immediate reconstruction is associated with greater upfront costs and length of stay, with costs rising at a steady pace over time.

This study by The American Journal of Surgery aimed to evaluate national trends in utilization, resource use, and predictors of immediate breast reconstruction (IR) after mastectomy.

The 2005–2014 National Inpatient Sample database was used to identify adult women undergoing mastectomy. IR was defined as any reconstruction during the same inpatient stay. Multivariable regression models were utilized to identify factors associated with IR.

--Of 729,340 patients undergoing mastectomy, 41.3% received IR.

--Rates of IR increased from 28.2% in 2005 to 58.2% in 2014.

--Compared to mastectomy alone, IR was associated with increased length of stay and hospitalization costs, which increased over time.

--Predictors of IR included younger age, fewer comorbidities, the White race, private insurance, top income quartile, teaching hospital designation, high mastectomy volume, and performance of bilateral mastectomy.

Conclusively, mastectomy with IR is increasingly performed with resource utilization rising at a steady pace. The study points to persistent sociodemographic and hospital-level disparities associated with the under-utilization of IR. Efforts are needed to alleviate disparities in IR.