Post-Mastectomy Chest Reconstruction in Male Breast Cancer Patients: A National Inpatient Sample Dat
Alexandra Bucknor, Renata Flecha-Hirsch, Austin Chen, Anmol Chattha, Sabine Egeler, Winona Wu, Samuel Lin
Beth Israel Deaconess Medical Center, Boston MA, USA
Background Among men, approximately 2,470 new cases of invasive breast cancer will be diagnosed in the United States in 2017. Despite the known benefits of breast reconstruction (BR) in women and increasing awareness of the disease in men, there is minimal discussion in the literature. This study aims to evaluate male post-mastectomy BR in the US. Methods Review of the Nationwide Inpatient Sample HealthCare Cost and Utilization Project database from 2008-2014 was performed; male breast cancer cases undergoing partial or total mastectomy with or without BR were identified. Demographics, procedures, and post-operative complications were evaluated. Results Overall, 3,220 (27.8%) men with a diagnosis of breast cancer (n=11,591) underwent a partial or total mastectomy. Of these, 24 (0.7%) underwent BR. Men undergoing BR were younger than those who were not, 57.0 vs. 66.7 years (p<0.001). Those not undergoing BR more frequently had Government/state-based insurance compared to those who did (62.8% vs. 32.5%, p=0.006), with a greater proportion of patients in the lowest income quartile (40.0% vs.23.2, p=0.022). Reconstruction subtypes included 42% autologous techniques (flap and/or fat grafting), while the remainder were implant-based or combined implant-autologous. Comparing those with and without BR, there were no significant differences in complications (p>0.05). Discussion Over one quarter of men with breast cancer required mastectomy, yet less than 1% of the men underwent breast reconstruction. Further research should elucidate whether this is patient preference, or whether development of a parallel pathway for reconstruction, such as exists for women, is warranted.
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