Clegg Devin J, Salomon Brett J, Porter Christopher G, Mazonas Thomas W, Heidel Robert E, Chun Joseph T, Herbig Kathleen S, Stephenson Stacy M, Lloyd Jillian M, Boukovalas Stefanos
Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tenn.
Department of Surgery, Division of Biostatistics, University of Tennessee Graduate School of Medicine, Knoxville, Tenn.
Plast Reconstr Surg Glob Open. 2023 Feb 2;11(2):e4802. doi: 10.1097/GOX.0000000000004802. eCollection 2023 Feb.
Factors that influence breast reconstruction after mastectomy have been previously examined in national databases. The purpose of this study was to determine the impact of patient travel distance and income on breast reconstruction after mastectomy in a rural population.
Retrospective review of mastectomy patients from 2017 to 2021 was performed from our prospectively enrolled tumor registry. Analysis included frequencies and percentages, descriptive statistics, analysis, independent sample tests, and multivariable analysis.
In total, 462 patients were included. Median BMI was 27.6 kg/m, 96.1% of patients were White, and median age at diagnosis was 60.0 years. Reconstruction rate was 52.6%, and median length of follow-up was 24.6 months. No significant difference was found in the distance traveled by patients who underwent reconstruction (16.6 versus 16.7 miles; = 0.94). Rates of reconstruction in patients who traveled 0-10 miles, 11-30 miles, and over 30 miles did not differ significantly ( = 0.16). Median household income was significantly different in reconstructed and nonreconstructed patients ($55,316.00 versus $51,629.00; = 0.047). Rates of reconstruction were significantly higher in patients with median household income greater than $65,000 ( = 0.024). This difference was not significant on multivariable analysis.
Travel distance did not significantly impact reconstruction rates after mastectomy, while household income did on univariable analysis. Studies at an institutional or regional level remain valuable, especially in populations that may not be accurately represented in larger database studies. Our findings highlight the importance of patient education, resource allocation, and multidisciplinary approach to breast cancer care, especially in the rural setting.
先前已在国家数据库中对影响乳房切除术后乳房重建的因素进行了研究。本研究的目的是确定患者出行距离和收入对农村地区乳房切除术后乳房重建的影响。
对我们前瞻性登记的肿瘤登记处2017年至2021年的乳房切除术患者进行回顾性研究。分析包括频率和百分比、描述性统计、分析、独立样本检验和多变量分析。
共纳入462例患者。中位BMI为27.6kg/m,96.1%的患者为白人,诊断时的中位年龄为60.0岁。重建率为52.6%,中位随访时间为24.6个月。接受重建的患者出行距离无显著差异(16.6英里对16.7英里;P = 0.94)。出行0至10英里、11至30英里和超过30英里的患者重建率无显著差异(P = 0.16)。重建患者和未重建患者的家庭收入中位数有显著差异(55,316.00美元对51,629.00美元;P = 0.047)。家庭收入中位数大于65,000美元的患者重建率显著更高(P = 0.024)。多变量分析时这种差异不显著。
出行距离对乳房切除术后的重建率没有显著影响,而家庭收入在单变量分析中有影响。机构或地区层面的研究仍然很有价值,尤其是在大型数据库研究可能无法准确代表的人群中。我们的研究结果强调了患者教育、资源分配以及乳腺癌护理多学科方法的重要性,尤其是在农村地区。