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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:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The national obesity epidemic is contributing to an increased proportion of overweight and obese breast cancer patients. Little is known about use of breast reconstruction among the obese, possible access barriers to reconstruction, and patient satisfaction. Our purpose was to determine if patterns of use and outcomes of reconstruction differed among obese and non-obese breast cancer patients. METHODS:: We performed a 5-year follow-up survey of mastectomy-treated breast cancer patients from the Los Angeles and Detroit SEER Cancer Registries (response rate 59%). Patients were divided into three body-mass index (BMI) categories: normal weight (BMI<25), overweight (BMI 25-30), and obese (BMI>30). The outcomes of interest were receipt of reconstruction, type and timing of reconstruction, access barriers, and satisfaction with the surgical decision and outcome. Chi-square and students t-test were used for analysis, and logistic regression was used to identify predictors of autologous reconstruction. RESULTS:: Of 374 mastectomy-treated patients, receipt of reconstruction did not vary by BMI (53% normal weight, 48% overweight, and 45% obese, p=0.43). Receipt did vary by type of reconstruction: significantly more obese patients received TRAM flaps vs. normal weight patients (53% vs. 26%, p=0.01). No specific access barriers to reconstruction were identified and patient satisfaction with surgical decision-making and surgical outcomes was similar across BMI categories. CONCLUSION:: Obese compared to 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 more challenging patient population. LEVEL OF EVIDENCE:: II.
Authors:
Anita R Kulkarni; Steven Katz; Ann S Hamilton; John J Graff; Amy K Alderman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-9
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  -     ISSN:  1529-4242     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1.Section of Plastic Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan. 2.Department of General Medicine, Department of Internal Medicine, The University of Michigan Medical Center, Ann Arbor, MI 3.Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 4.New Jersey State Cancer Registry, Cancer Institute of New Jersey, New Brunswick, NJ 5.Private practice, Atlanta, Georgia.
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