Evidence map›Paper›PMID 35674701›Full record

Observational studyBJS open2022

Patient-level costs of staged unilateral versus immediate bilateral symmetrization mammoplasty in breast-conserving surgery.

Yasmin Grant, Paul T R Thiruchelvam, Lana Kovacevic, Elias Mossialos, Ragheed Al-Mufti, Katy Hogben, Dimitri J Hadjiminas, Daniel R Leff

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BJS open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Yasmin GrantDepartment of BioSurgery and Surgical Technology, Imperial College London, London, UK.
Paul T R ThiruchelvamBreast Unit, Imperial College Healthcare NHS Trust, London, UK.
Lana KovacevicDepartment of Health Policy, The London School of Economics and Political Science, London, UK.
Elias MossialosBreast Unit, Imperial College Healthcare NHS Trust, London, UK.ORCID 0000-0001-8664-9297
Ragheed Al-MuftiBreast Unit, Imperial College Healthcare NHS Trust, London, UK.
Katy HogbenBreast Unit, Imperial College Healthcare NHS Trust, London, UK.
Dimitri J HadjiminasBreast Unit, Imperial College Healthcare NHS Trust, London, UK.
Daniel R LeffDepartment of BioSurgery and Surgical Technology, Imperial College London, London, UK.ORCID 0000-0001-5921-823X
Imperial College Healthcare NHS Trust · GBImperial College London · GBLondon School of Economics and Political Science · GB

Funding

Department of Health
6 · The paper itself

Abstract

backgroundFollowing therapeutic mammoplasty (TM), the contralateral breast may require a later balancing procedure to optimize shape and symmetry. The alternative is to offer patients simultaneous TM with immediate contralateral symmetrization via a dual-surgeon approach, with the goal of reducing costs and minimizing the number of subsequent hospital appointments in an era of COVID-19 surges. The aim of this cost-consequence analysis is to characterize the cost-benefit of immediate bilateral symmetrization dual-operator mammoplasty versus staged unilateral single operator for breast cancer surgery.

methodA prospective single-centre observational study was conducted at an academic teaching centre for breast cancer surgery in the UK. Pseudonymized data for clinicopathological variables and procedural care information, including the type of initial breast-conserving surgery and subsequent reoperation(s), were extracted from the electronic patient record. Financial data were retrieved using the Patient-Level Information and Costing Systems.

resultsBetween April 2014 and March 2020, 232 women received either immediate bilateral (n = 44), staged unilateral (n = 57) for breast cancer, or unilateral mammoplasty alone (n = 131). The median (interquartile range (i.q.r.)) additional cost of unilateral mammoplasty with staged versus immediate bilateral mammoplasty was €5500 (€4330 to €6570) per patient (P < 0.001), which represents a total supplementary financial burden of €313 462 to the study institution. There was no significant difference between groups in age, Charlson comorbidity index, operating minutes, time to adjuvant radiotherapy in months, or duration of hospital stay.

conclusionSynchronous dual-surgeon immediate bilateral TM can deliver safe immediate symmetrization and is financially beneficial, without delay to receipt of adjuvant therapy, or additional postoperative morbidity.

Indexed as

Breast NeoplasmsCOVID-19MammaplastyFemaleHumansMastectomy, SegmentalProspective StudiesTreatment Outcome

Identifiers

PMID35674701
PMCPMC9176201
OpenAlexW4226027731

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.