Evidence map›Paper›PMID 38636184›Full record

ArticleThe Journal of surgical research2024

Are There Disparities in Breast Reconstruction After Contralateral Prophylactic Mastectomy?

Courtney M Lattimore, Max O Meneveau, Raj Desai, T Fabian Camacho, Gabriella C Squeo, Shayna L Showalter

Open access · greenAbstract read
In one paragraph

Article in The Journal of surgical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 35% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

6 authors at 1 institution in 1 country.

Courtney M LattimoreDepartment of Surgery, University of Virginia Health System, Charlottesville, Virginia.
Max O MeneveauDepartment of Surgery, University of Virginia Health System, Charlottesville, Virginia.
Raj DesaiDivision of Translational Research & Applied Statistics, Department of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia.
T Fabian CamachoDivision of Translational Research & Applied Statistics, Department of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia.
Gabriella C SqueoDepartment of Plastic and Maxillofacial Surgery, University of Virginia Health System, Charlottesville, Virginia.
Shayna L ShowalterDepartment of Surgery, University of Virginia Health System, Charlottesville, Virginia. Electronic address: snl2t@uvahealth.org.
University of Virginia Health System · US

Funding

Postdoctoral Training Grant for MDs in Surgical Oncology ResearchT32CA163177 · NCI · UNIVERSITY OF VIRGINIA · PI Craig Lee Slingluff, Allan Tsung · 2011 to 2026
$4.6M
NCI NIH HHS T32 CA163177
6 · The paper itself

Abstract

introductionDespite national guidelines against contralateral prophylactic mastectomy (CPM) in low- to moderate-risk breast cancer, CPM use continues to rise. Breast reconstruction improves health-related quality of life and satisfaction among women undergoing mastectomy. Given the lack of data regarding factors associated with reconstruction after CPM and the known benefits of reconstruction, we sought to investigate whether disparities exist in receipt of reconstruction after CPM.

methodsThe 2004-2017 National Cancer Database was queried to identify women diagnosed with breast cancer who underwent unilateral mastectomy with CPM. Patients were divided into two groups: those who underwent planned reconstruction at any timepoint and those who did not. A secondary analysis comparing types of reconstruction (tissue, implant, combined) was conducted. Patient, tumor, and demographic characteristics were analyzed using chi-square test and odds ratios were calculated using generalized estimating equations.

resultsThe cohort included 1,73,249 women: 95,818 (55.3%) underwent reconstruction and 77,431 (45.7%) did not. Both the rate CPM and the proportion of women undergoing reconstruction after CPM increased between 2004 and 2017. Of the women who had reconstruction, 40,840 (51.7%) received implants, 29,807 (37.7%) had tissue, and 8352 (10.6%) had combined reconstruction. After adjusted analysis, factors associated with reconstruction were young age, Hispanic ethnicity, private insurance, and living in an area with the highest education and median income (P < 0.01). Patients who underwent reconstruction were less likely to have radiation (P < 0.01) and chemotherapy (P < 0.01), more likely to have stage I disease (P < 0.01), and to be treated at an integrated cancer center (P < 0.01).

conclusionsReconstruction after CPM is disproportionately received by younger women, Hispanics, those with private insurance, and higher socioeconomic status and education. While the rate of reconstruction after CPM is increasing, there remain significant disparities. Conscious efforts must be made to eliminate these disparities, especially given the known benefits of reconstruction after mastectomy.

Indexed as

Breast NeoplasmsHealthcare DisparitiesMammaplastyProphylactic MastectomyAdultAgedFemaleHumansMiddle AgedRetrospective StudiesUnited StatesBreastCancerContralateralMastectomyProphylacticReconstruction

Identifiers

PMID38636184
PMCPMC11144118
OpenAlexW4394871046

What OpenQuestion holds

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Registered trials

None linked

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.