Factors predictive of immediate breast reconstruction following mastectomy for invasive breast cancer in Australia

Abstract

<h4>Purpose</h4>To investigate person, cancer and treatment determinants of immediate breast reconstruction (IBR) in Australia.<h4>Methods</h4>Bi-variable and multi-variable analyses of the Quality Audit database.<h4>Results</h4>Of 12,707 invasive cancers treated by mastectomy circa 1998-2010, 8% had IBR. This proportion increased over time and reduced from 29% in women below 30 years to approximately 1% in those aged 70 years or more. Multiple regression indicated that other IBR predictors included: high socio-economic status; private health insurance; being asymptomatic; a metropolitan rather than inner regional treatment centre; higher surgeon case load; small tumour size; negative nodal status, positive progesterone receptor status; more cancer foci; multiple affected breast quadrants; synchronous bilateral cancer; not having neo-adjuvant chemotherapy, adjuvant radiotherapy or adjuvant hormone therapy; and receiving ovarian ablation.<h4>Conclusions</h4>Variations in access to specialty services and other possible causes of variations in IBR rates need further investigation.