Nottingham Breast Cancer Research Centre, University of Nottingham, Nottingham, UK.
Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Br J Surg. 2022 Oct 14;109(11):1063-1072. doi: 10.1093/bjs/znac251.
Postmastectomy immediate breast reconstruction (PMIBR) may improve the quality of life of patients with breast cancer, of whom older women (aged 65 years or more) are a growing proportion. This study aimed to assess PMIBR in older women with regard to underlying impediments (if any).
MEDLINE, Embase, and PubMed were searched by two independent researchers up to June 2022. Eligible studies compared PMIBR rates between younger and older women with invasive primary breast cancer.
A total of 10 studies (2012-2020) including 466 134 women were appraised, of whom two-thirds (313 298) were younger and one-third (152 836) older. Only 10.0 per cent of older women underwent PMIBR in contrast to 45.0 per cent of younger women. Two studies explored factors affecting uptake of PMIBR in older women; surgeon-associated (usual practice), patient-associated (socioeconomic status, ethnicity, and co-morbidities), and system-associated (insurance status and hospital location) factors were identified.
Uptake of PMIBR in older women is low with definable (and some correctable) barriers.
乳腺癌术后即刻乳房重建（PMIBR）可能提高患者的生活质量，其中老年女性（年龄 65 岁及以上）的比例不断增加。本研究旨在评估 PMIBR 对老年女性的影响，以及可能存在的障碍。
两位独立研究者检索了 MEDLINE、Embase 和 PubMed 数据库，截至 2022 年 6 月。纳入的研究比较了浸润性原发性乳腺癌年轻女性和老年女性之间的 PMIBR 率。
共评估了 10 项研究（2012-2020 年），纳入 466134 名女性，其中三分之二（313298 名）为年轻女性，三分之一（152836 名）为老年女性。仅有 10.0%的老年女性接受了 PMIBR，而年轻女性的这一比例为 45.0%。有两项研究探讨了影响老年女性接受 PMIBR 的因素；发现了与外科医生相关（常规做法）、与患者相关（社会经济地位、种族和合并症）和与系统相关（保险状况和医院位置）的因素。
老年女性接受 PMIBR 的比例较低，存在明确的（且部分可纠正的）障碍。
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