Document Detail

Utilization of mastectomy and reconstruction in the outpatient setting.
MedLine Citation:
PMID:  22990647     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Reconstruction rates after mastectomy have been reported to range from 25-40%; however, most studies have focused on patients treated in an inpatient setting. We sought to determine the utilization of outpatient mastectomy and use of breast reconstruction in Southern California.
METHODS: Postmastectomy reconstruction rates were determined from the California Office of Statewide Health Planning and Development database from 2006-2009 using CPT codes and similarly from an inpatient database using ICD-9 codes. Reconstruction rates were compared between the inpatient and outpatient setting. For the outpatient setting, univariate and multivariate odds ratios with 95% confidence intervals were estimated for relative odds of immediate reconstruction versus mastectomy alone.
RESULTS: The percentage of patients undergoing outpatient mastectomy ranged from 20.4 to 23.9% of the total number of all patients undergoing mastectomy. Whereas immediate inpatient reconstruction increased from 29.2 to 41.6% (overall rate 35.5%), the proportion of outpatients undergoing reconstruction only increased from 7.7 to 10.3% (overall rate 9.1%). Similar to the inpatient setting, in multivariate analysis, age, insurance status, race/ethnicity, and type of hospital were significantly associated with the use of reconstruction in the outpatient setting.
CONCLUSIONS: A substantial number of patients undergo outpatient mastectomy with low rates of reconstruction. Although the choice of an outpatient mastectomy may certainly represent a selection bias for those not choosing reconstruction, an increase in the use of outpatient mastectomy may result in decreases in the use of postmastectomy reconstruction.
Laura Kruper; Xin Xin Xu; Katherine Henderson; Leslie Bernstein; Steven L Chen
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Publication Detail:
Type:  Journal Article     Date:  2012-09-19
Journal Detail:
Title:  Annals of surgical oncology     Volume:  20     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-18     Completed Date:  2013-08-06     Revised Date:  2014-03-09    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  828-35     Citation Subset:  IM    
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MeSH Terms
Breast Neoplasms / classification,  pathology,  surgery*
Carcinoma, Intraductal, Noninfiltrating / classification,  pathology,  surgery*
Follow-Up Studies
International Classification of Diseases
Mammaplasty / utilization*
Mastectomy / utilization*
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Outpatients / statistics & numerical data*
Grant Support

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

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