Department of Surgery, New York University School of Medicine, NY.
University of Miami Miller School of Medicine, FL; Jackson Memorial Hospital, Miami, FL.
Surgery. 2022 Jul;172(1):25-30. doi: 10.1016/j.surg.2022.01.036. Epub 2022 Feb 28.
Racial disparities in accessing postmastectomy breast reconstruction persist despite expansion of insurance coverage. An updated examination with a broad assessment of mediating factors in a "majority minority" community is needed.
Data were collected on all patients undergoing mastectomy for breast cancer from 2011 to 2019 in a private academic center and adjacent safety-net hospital. Multivariable logistic regression was used to assess the effect of race on postmastectomy breast reconstruction, controlling for predetermined potentially mediating and confounding variables.
Of 1,554 patients, 63.8% (n = 203) of non-Hispanic White, 33.4% (n = 102) of Black, and 47.9% (n = 438) of Hispanic patients underwent postmastectomy breast reconstruction. Multivariable logistic regression showed that Black patients (odds ratio [OR] 3.6, 95% confidence internal [CI]: 2.2-5.9; P < .0001) undergo significantly less postmastectomy breast reconstruction than White patients. Age, insurance status, stage, and hospital type mediated this relationship.
Black patients have substantially reduced rates of postmastectomy breast reconstruction compared with White patients, which is mediated by socioeconomic factors.
尽管保险范围扩大，但在接受乳房再造术方面仍存在种族差异。在“多数少数族裔”社区中，需要进行一次更广泛的评估，以更新对调解因素的检查。
从 2011 年至 2019 年，在一家私立学术中心和毗邻的安全网医院，对所有接受乳房切除术治疗乳腺癌的患者进行了数据收集。采用多变量逻辑回归来评估种族对乳房再造术后的影响，同时控制预先确定的潜在调解和混杂变量。
在 1554 名患者中，63.8%（n=203）为非西班牙裔白人，33.4%（n=102）为黑人，47.9%（n=438）为西班牙裔患者接受了乳房再造术。多变量逻辑回归显示，黑人患者（比值比 [OR] 3.6，95%置信区间 [CI]：2.2-5.9；P<.0001）接受乳房再造术的比例明显低于白人患者。年龄、保险状况、分期和医院类型调解了这种关系。
与白人患者相比，黑人患者乳房再造术的比例大大降低，这是由社会经济因素介导的。
