Allan Jessica, Locke Michelle, Wagener Jenny
Faculty of Medicine and Health Science, The University of Auckland, Auckland, New Zealand.
Department of Plastic and Reconstructive Surgery, Middlemore Hospital, Auckland, New Zealand.
ANZ J Surg. 2020 Jul;90(7-8):1402-1407. doi: 10.1111/ans.15894. Epub 2020 May 14.
Post-mastectomy breast reconstruction (PMBR) is associated with greater quality of life and psychological well-being. However, rates of PMBR may not be equivalent across all ethnicities which contributes to disparities in health outcomes.
A retrospective review of patients diagnosed with breast cancer between 1 January and 31 December 2017 at Counties Manukau District Health Board (CMDHB) was performed. Data regarding patient demographics, cancer stage, breast cancer treatment and whether reconstruction took place were collected. These data were analysed to assess the rates of reconstruction by ethnic group.
A total of 365 patients were diagnosed with cancer in CMDHB breast cancer clinic in 2017. Of these, 177 were treated with mastectomy and 26 (15%) of these patients received PMBR. Thirty-four percent of patients receiving mastectomy were of Māori or Pasifika ethnicity. Of these patients, one-third met the eligibility criteria for PMBR at CMDHB, having body mass index <35 and being non-smokers. Māori women represented only 4% of the PMBR performed at CMDHB in 2017. European women comprised 50% of all mastectomies but received 77% of all PMBR. There was a significant difference in eligibility between the different ethnic groups for PMBR, due to higher body mass index and higher rates of smoking in Māori and Pasifika patients.
Eligibility rates for post-mastectomy reconstruction are significantly lower (P < 0.05) in Māori and Pasifika women when compared with European and Asian populations. Strategies to address smoking and obesity may help increase rates of PMBR in Māori and Pasifika women.
乳房切除术后乳房重建（PMBR）与更高的生活质量和心理健康相关。然而，PMBR的发生率在所有种族中可能并不相同，这导致了健康结果的差异。
对2017年1月1日至12月31日在考伊蒂马努考地区卫生局（CMDHB）被诊断为乳腺癌的患者进行回顾性研究。收集了有关患者人口统计学、癌症分期、乳腺癌治疗以及是否进行重建的数据。对这些数据进行分析以评估不同种族的重建率。
2017年CMDHB乳腺癌诊所共有365名患者被诊断患有癌症。其中，177名患者接受了乳房切除术，其中26名（15%）患者接受了PMBR。接受乳房切除术的患者中有34%为毛利族或太平洋岛民族裔。在这些患者中，三分之一符合CMDHB的PMBR资格标准，即体重指数<35且不吸烟。2017年，毛利族女性仅占CMDHB进行的PMBR的4%。欧洲女性占所有乳房切除术患者的50%，但接受了所有PMBR的77%。由于毛利族和太平洋岛民患者的体重指数较高和吸烟率较高，不同种族之间PMBR的资格存在显著差异。
与欧洲和亚洲人群相比，毛利族和太平洋岛民女性乳房切除术后重建的资格率显著较低（P < 0.05）。解决吸烟和肥胖问题的策略可能有助于提高毛利族和太平洋岛民女性的PMBR率。
