Document Detail


Patterns of use and patient satisfaction with breast reconstruction among obese patients: results from a population-based study.
MedLine Citation:
PMID:  22495206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The national obesity epidemic is contributing to an increased proportion of overweight and obese breast cancer patients. The authors' purpose was to determine whether patterns of use and outcomes of reconstruction differed among obese and nonobese patients.
METHODS: The authors performed a 5-year follow-up survey of mastectomy-treated breast cancer patients from the Los Angeles and Detroit Surveillance, Epidemiology and End Results Cancer Registries (response rate, 59 percent). Patients were divided into three body mass index categories: normal weight (body mass index<25 kg/m), overweight (25 to 30 kg/m), and obese (>30 kg/m). Outcomes of interest were receipt of reconstruction, type and timing of reconstruction, access barriers, and satisfaction. Chi-square and t tests were used for analysis. Logistic regression was used to identify predictors of autologous reconstruction.
RESULTS: Of 374 mastectomy-treated patients, receipt of reconstruction did not vary by body mass index (53 percent normal weight, 48 percent overweight, and 45 percent obese; p=0.43). Receipt did vary by type of reconstruction: significantly more obese patients received transverse rectus abdominis musculocutaneous flaps compared with normal weight patients (53 percent versus 26 percent; p=0.01). No specific access barriers to reconstruction were identified. Patient satisfaction with surgical decision-making and surgical outcomes was similar across body mass index categories.
CONCLUSIONS: Obese compared with normal weight breast cancer patients have similar use of breast reconstruction, are more likely to receive an autologous procedure, and report similar satisfaction with surgical outcomes. Future efforts should be directed at decreasing the surgical risk in this challenging patient population.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
Authors:
Anita R Kulkarni; Steven Katz; Ann S Hamilton; John J Graff; Amy K Alderman
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  130     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-31     Completed Date:  2012-10-09     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  263-70     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Body Mass Index
Breast Neoplasms / complications,  surgery*
Carcinoma, Ductal, Breast / complications,  surgery
Carcinoma, Intraductal, Noninfiltrating / complications,  surgery
Chi-Square Distribution
Female
Follow-Up Studies
Health Services Accessibility*
Humans
Logistic Models
Los Angeles
Mammaplasty* / methods
Mastectomy*
Michigan
Middle Aged
Obesity / complications*
Patient Satisfaction / statistics & numerical data*
Prospective Studies
Questionnaires
Registries
Surgical Flaps
Grant Support
ID/Acronym/Agency:
K05CA111340/CA/NCI NIH HHS; N01-PC-35139/PC/NCI NIH HHS; N01-PC-65064/PC/NCI NIH HHS; R01 CA8837/CA/NCI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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