Article type: Research Article
Authors: Huayllani, Maria T.a | Torres-Guzman, Ricardo A.a | Avila, Francisco R.a | Advani, Pooja P.b | Spaulding, Aaron C.c | Cochuyt, Jordan J.c | Nguyen, Minh-Doan T.d | Lu, Xiaonae | Rinker, Brian D.a | Forte, Antonio J.a;
Affiliations: [a] Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA | [b] Department of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA | [c] Department of Health Science Research, Mayo Clinic, Jacksonville, FL, USA | [d] Division of Plastic Surgery, Mayo Clinic, Rochester, MN, USA | [e] Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA
Correspondence:
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Corresponding author: Antonio J. Forte, Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224, USA. Tel.: +1 9049532073; E-mail: [email protected]
Abstract: INTRODUCTION:Disparities in access to reconstructive surgery after breast cancer have been reported. We aim to evaluate demographic and socioeconomic factors influencing type of autologous breast reconstruction in Florida. METHODS:We queried the Florida Inpatient Discharge Dataset to evaluate disparities in type of autologous breast reconstructive surgery between January 1, 2013, and September 30, 2017. Patients 18 years of age or older were included. Women younger than 65 years old on Medicare were excluded. Patients were categorized into three groups according to type of autologous reconstruction: latissimus dorsi pedicled flap (pedicled flap), free flap, or pedicled flap with implant (combined flap). Demographic and socioeconomic variables were evaluated. 𝜒2 and Mann–Whitney tests were used to estimate statistical significance. A multivariate logistic regression was performed to find independent associations. RESULTS:Our results showed higher odds of reconstruction with free flap in Hispanic patients (odds ratio (OR), 1.66; 95% CI, 1.32–2.09; P < 0.0001) and patients with comorbidities (OR, 1.45; 95% CI, 1.23–1.71; P < 0.0001). However, patients treated in Central and South Florida were less likely to undergo free flap than combined and pedicled flap reconstructions compared with those treated in North Florida (P < 0.05). Patients insured by Medicaid and Medicare were less likely to undergo free flap than combined or pedicled flap reconstruction compared to patients with private insurance (P < 0.05). CONCLUSIONS:Our study identified that race, region, insurance, and comorbidity are factors associated with type of autologous breast reconstruction in Florida.
Keywords: Malignant breast disease, reconstructive surgery, breast reconstruction, disparities, race, insurance
DOI: 10.3233/BD-210004
Journal: Breast Disease, vol. 41, no. 1, pp. 75-80, 2022
Published: 05 November 2021
