Skip to main content
Erschienen in: Current Breast Cancer Reports 3/2020

15.05.2020 | Breast Cancer Disparities (LA Newman, Section Editor)

Breast Reconstruction Disparities in the United States and Internationally

verfasst von: Sarah E. Hart, Adeyiza O. Momoh

Erschienen in: Current Breast Cancer Reports | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Women electing to undergo breast reconstruction following mastectomy have increased in frequency. Classically studied healthcare disparities have an influence on whether women undergo reconstruction. This review evaluates these domains, globally, while exploring why they exist.

Recent Findings

In the USA, women who are young, white, with higher income and education level, private insurance, and those treated at private or academic hospitals are most likely to undergo reconstruction. Women of a minority race or ethnicity, lower socioeconomic group, early education status, and with public or no insurance remain less likely to undergo reconstruction. Breast reconstruction is not commonly available to women in low- and middle-income countries.

Summary

Disparities in breast reconstruction persist though significant strides have been made in many high-income nations. Internationally, concerted efforts are needed that focus on health literacy education, access to surgical consultations, and an inclusion of breast reconstruction in the breast cancer treatment process.
Literatur
2.
Zurück zum Zitat Kummerow KL, Du L, Penson DF, Shyr Y, Hooks MA. Nationwide trends in mastectomy for early-stage breast cancer. JAMA Surg. 2015;150(1):9–16.PubMed Kummerow KL, Du L, Penson DF, Shyr Y, Hooks MA. Nationwide trends in mastectomy for early-stage breast cancer. JAMA Surg. 2015;150(1):9–16.PubMed
3.
Zurück zum Zitat Portschy PR, Tuttle TM. Rise of mastectomy. J Surg Oncol. 2013;107(6):563–4.PubMed Portschy PR, Tuttle TM. Rise of mastectomy. J Surg Oncol. 2013;107(6):563–4.PubMed
4.
Zurück zum Zitat Stucky CC, Gray RJ, Wasif N, Dueck AC, Pockaj BA. Increase in contralateral prophylactic mastectomy: echoes of a bygone era? Surgical trends for unilateral breast cancer. Ann Surg Oncol. 2010;17(Suppl 3):330–7.PubMed Stucky CC, Gray RJ, Wasif N, Dueck AC, Pockaj BA. Increase in contralateral prophylactic mastectomy: echoes of a bygone era? Surgical trends for unilateral breast cancer. Ann Surg Oncol. 2010;17(Suppl 3):330–7.PubMed
5.
Zurück zum Zitat Tracy MS, Rosenberg SM, Dominici L, Partridge AH. Contralateral prophylactic mastectomy in women with breast cancer: trends, predictors, and areas for future research. Breast Cancer Res Treat. 2013;140(3):447–52.PubMed Tracy MS, Rosenberg SM, Dominici L, Partridge AH. Contralateral prophylactic mastectomy in women with breast cancer: trends, predictors, and areas for future research. Breast Cancer Res Treat. 2013;140(3):447–52.PubMed
6.
Zurück zum Zitat Mahmood U, Hanlon AL, Koshy M, Buras R, Chumsri S, Tkaczuk KH, et al. Increasing national mastectomy rates for the treatment of early stage breast cancer. Ann Surg Oncol. 2013;20(5):1436–43.PubMed Mahmood U, Hanlon AL, Koshy M, Buras R, Chumsri S, Tkaczuk KH, et al. Increasing national mastectomy rates for the treatment of early stage breast cancer. Ann Surg Oncol. 2013;20(5):1436–43.PubMed
7.
Zurück zum Zitat Agarwal S, Pappas L, Neumayer L, Agarwal J. An analysis of immediate postmastectomy breast reconstruction frequency using the surveillance, epidemiology, and end results database. Breast J. 2011;17(4):352–8.PubMed Agarwal S, Pappas L, Neumayer L, Agarwal J. An analysis of immediate postmastectomy breast reconstruction frequency using the surveillance, epidemiology, and end results database. Breast J. 2011;17(4):352–8.PubMed
8.
Zurück zum Zitat Alderman AK, Wei Y, Birkmeyer JD. Use of breast reconstruction after mastectomy following the Women’s Health and Cancer Rights Act. JAMA. 2006;295(4):387–8.PubMed Alderman AK, Wei Y, Birkmeyer JD. Use of breast reconstruction after mastectomy following the Women’s Health and Cancer Rights Act. JAMA. 2006;295(4):387–8.PubMed
9.
Zurück zum Zitat Pusic AL, Chen CM, Cano S, Klassen A, McCarthy C, Collins ED, et al. Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments. Plast Reconstr Surg. 2007;120(4):823–37 discussion 38-9.PubMed Pusic AL, Chen CM, Cano S, Klassen A, McCarthy C, Collins ED, et al. Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments. Plast Reconstr Surg. 2007;120(4):823–37 discussion 38-9.PubMed
10.
Zurück zum Zitat Winters ZE, Benson JR, Pusic AL. A systematic review of the clinical evidence to guide treatment recommendations in breast reconstruction based on patient-reported outcome measures and health-related quality of life. Ann Surg. 2010;252(6):929–42.PubMed Winters ZE, Benson JR, Pusic AL. A systematic review of the clinical evidence to guide treatment recommendations in breast reconstruction based on patient-reported outcome measures and health-related quality of life. Ann Surg. 2010;252(6):929–42.PubMed
11.
Zurück zum Zitat Dean C, Chetty U, Forrest AP. Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. Lancet. 1983;1(8322):459–62.PubMed Dean C, Chetty U, Forrest AP. Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. Lancet. 1983;1(8322):459–62.PubMed
12.
Zurück zum Zitat Schain WS. Breast reconstruction. Update of psychosocial and pragmatic concerns. Cancer. 1991;68(5 Suppl):1170–5.PubMed Schain WS. Breast reconstruction. Update of psychosocial and pragmatic concerns. Cancer. 1991;68(5 Suppl):1170–5.PubMed
13.
Zurück zum Zitat Cederna PS, Yates WR, Chang P, Cram AE, Ricciardelli EJ. Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction. Ann Plast Surg. 1995;35(5):458–68.PubMed Cederna PS, Yates WR, Chang P, Cram AE, Ricciardelli EJ. Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction. Ann Plast Surg. 1995;35(5):458–68.PubMed
14.
Zurück zum Zitat Wilkins EG, Alderman AK. Breast reconstruction practices in North America: current trends and future priorities. Semin Plast Surg. 2004;18(2):149–55.PubMedPubMedCentral Wilkins EG, Alderman AK. Breast reconstruction practices in North America: current trends and future priorities. Semin Plast Surg. 2004;18(2):149–55.PubMedPubMedCentral
15.
Zurück zum Zitat • Jagsi R, Jiang J, Momoh AO, Alderman A, Giordano SH, Buchholz TA, et al. Trends and variation in use of breast reconstruction in patients with breast cancer undergoing mastectomy in the United States. J Clin Oncol. 2014;32(9):919–26. This study evaluated time trends and variation of reconstruction based on plastic-surgery workforce density showing increasing rates of reconstruction over time but large geograpic variability. PubMedPubMedCentral • Jagsi R, Jiang J, Momoh AO, Alderman A, Giordano SH, Buchholz TA, et al. Trends and variation in use of breast reconstruction in patients with breast cancer undergoing mastectomy in the United States. J Clin Oncol. 2014;32(9):919–26. This study evaluated time trends and variation of reconstruction based on plastic-surgery workforce density showing increasing rates of reconstruction over time but large geograpic variability. PubMedPubMedCentral
16.
Zurück zum Zitat Reddy KG, Strassle PD, McGuire KP. Role of age, tumor grade, and radiation therapy on immediate postmastectomy breast reconstruction. Clin Breast Cancer. 2018;18(4):313–9.PubMed Reddy KG, Strassle PD, McGuire KP. Role of age, tumor grade, and radiation therapy on immediate postmastectomy breast reconstruction. Clin Breast Cancer. 2018;18(4):313–9.PubMed
17.
Zurück zum Zitat de Jager E, Levine AA, Udyavar NR, Burstin HR, Bhulani N, Hoyt DB, et al. Disparities in surgical access: a systematic literature review, conceptual model, and evidence map. J Am Coll Surg. 2019;228(3):276–98.PubMedPubMedCentral de Jager E, Levine AA, Udyavar NR, Burstin HR, Bhulani N, Hoyt DB, et al. Disparities in surgical access: a systematic literature review, conceptual model, and evidence map. J Am Coll Surg. 2019;228(3):276–98.PubMedPubMedCentral
18.
Zurück zum Zitat Morrow M, Li Y, Alderman AK, Jagsi R, Hamilton AS, Graff JJ, et al. Access to breast reconstruction after mastectomy and patient perspectives on reconstruction decision making. JAMA Surg. 2014;149(10):1015–21.PubMedPubMedCentral Morrow M, Li Y, Alderman AK, Jagsi R, Hamilton AS, Graff JJ, et al. Access to breast reconstruction after mastectomy and patient perspectives on reconstruction decision making. JAMA Surg. 2014;149(10):1015–21.PubMedPubMedCentral
19.
Zurück zum Zitat Kamali P, Zettervall SL, Wu W, Ibrahim AM, Medin C, Rakhorst HA, et al. Differences in the reporting of racial and socioeconomic disparities among three large national databases for breast reconstruction. Plast Reconstr Surg. 2017;139(4):795–807.PubMed Kamali P, Zettervall SL, Wu W, Ibrahim AM, Medin C, Rakhorst HA, et al. Differences in the reporting of racial and socioeconomic disparities among three large national databases for breast reconstruction. Plast Reconstr Surg. 2017;139(4):795–807.PubMed
20.
Zurück zum Zitat Greenberg CC, Schneider EC, Lipsitz SR, Ko CY, Malin JL, Epstein AM, et al. Do variations in provider discussions explain socioeconomic disparities in postmastectomy breast reconstruction? J Am Coll Surg. 2008;206(4):605–15.PubMedPubMedCentral Greenberg CC, Schneider EC, Lipsitz SR, Ko CY, Malin JL, Epstein AM, et al. Do variations in provider discussions explain socioeconomic disparities in postmastectomy breast reconstruction? J Am Coll Surg. 2008;206(4):605–15.PubMedPubMedCentral
21.
Zurück zum Zitat Butler PD, Familusi O, Serletti JM, Fox JP. Influence of race, insurance status, and geographic access to plastic surgeons on immediate breast reconstruction rates. Am J Surg. 2018;215(6):987–94.PubMed Butler PD, Familusi O, Serletti JM, Fox JP. Influence of race, insurance status, and geographic access to plastic surgeons on immediate breast reconstruction rates. Am J Surg. 2018;215(6):987–94.PubMed
22.
Zurück zum Zitat Joslyn SA. Patterns of care for immediate and early delayed breast reconstruction following mastectomy. Plast Reconstr Surg. 2005;115(5):1289–96.PubMed Joslyn SA. Patterns of care for immediate and early delayed breast reconstruction following mastectomy. Plast Reconstr Surg. 2005;115(5):1289–96.PubMed
23.
Zurück zum Zitat • Sharma K, Grant D, Parikh R, Myckatyn T. Race and breast cancer reconstruction: is there a health care disparity? Plast Reconstr Surg. 2016;138(2):354–61. This study used multivariate logistic regression to identify independent predictors of breast reconstruction type by race. The analysis demonstrated that African American race is a significant predictor of autologous breast reconstruction. PubMed • Sharma K, Grant D, Parikh R, Myckatyn T. Race and breast cancer reconstruction: is there a health care disparity? Plast Reconstr Surg. 2016;138(2):354–61. This study used multivariate logistic regression to identify independent predictors of breast reconstruction type by race. The analysis demonstrated that African American race is a significant predictor of autologous breast reconstruction. PubMed
24.
Zurück zum Zitat Alderman AK, Hawley ST, Janz NK, Mujahid MS, Morrow M, Hamilton AS, et al. Racial and ethnic disparities in the use of postmastectomy breast reconstruction: results from a population- based study. J Clin Oncol. 2009;27(32):5325–30.PubMedPubMedCentral Alderman AK, Hawley ST, Janz NK, Mujahid MS, Morrow M, Hamilton AS, et al. Racial and ethnic disparities in the use of postmastectomy breast reconstruction: results from a population- based study. J Clin Oncol. 2009;27(32):5325–30.PubMedPubMedCentral
25.
Zurück zum Zitat Panieri E, Lazarus D, Dent DM, Hudson DA, Murray E, Werner ID. A study of the patient factors affecting reconstruction after mastectomy for breast carcinoma. Am Surg. 2003;69(2):95–7.PubMed Panieri E, Lazarus D, Dent DM, Hudson DA, Murray E, Werner ID. A study of the patient factors affecting reconstruction after mastectomy for breast carcinoma. Am Surg. 2003;69(2):95–7.PubMed
26.
Zurück zum Zitat Yang RL, Newman AS, Lin IC, Reinke CE, Karakousis GC, Czerniecki BJ, et al. Trends in immediate breast reconstruction across insurance groups after enactment of breast cancer legislation. Cancer. 2013;119(13):2462–8.PubMed Yang RL, Newman AS, Lin IC, Reinke CE, Karakousis GC, Czerniecki BJ, et al. Trends in immediate breast reconstruction across insurance groups after enactment of breast cancer legislation. Cancer. 2013;119(13):2462–8.PubMed
27.
Zurück zum Zitat Lang JE, Summers DE, Cui H, Carey JN, Viscusi RK, Hurst CA, et al. Trends in post-mastectomy reconstruction: a SEER database analysis. J Surg Oncol. 2013;108(3):163–8.PubMedPubMedCentral Lang JE, Summers DE, Cui H, Carey JN, Viscusi RK, Hurst CA, et al. Trends in post-mastectomy reconstruction: a SEER database analysis. J Surg Oncol. 2013;108(3):163–8.PubMedPubMedCentral
28.
Zurück zum Zitat •• Sergesketter AR, Thomas SM, Lane WO, Orr JP, Shammas RL, Fayanju OM, et al. Decline in racial disparities in postmastectomy breast reconstruction: a surveillance, epidemiology, and end results analysis from 1998 to 2014. Plast Reconstr Surg. 2019;143(6):1560–70. This study used the SEER database to perform multivariable regressions to evaluate demographic factors associated with undergoing reconstruction and to predict reconstruction subtype. Changes over time were also evaluated by race and ethnicity. Their analysis demonstrated that breast reconstruction rates have increased overtime more quickly for minority patients, and that race is associated with different types of reconstruction. PubMedPubMedCentral •• Sergesketter AR, Thomas SM, Lane WO, Orr JP, Shammas RL, Fayanju OM, et al. Decline in racial disparities in postmastectomy breast reconstruction: a surveillance, epidemiology, and end results analysis from 1998 to 2014. Plast Reconstr Surg. 2019;143(6):1560–70. This study used the SEER database to perform multivariable regressions to evaluate demographic factors associated with undergoing reconstruction and to predict reconstruction subtype. Changes over time were also evaluated by race and ethnicity. Their analysis demonstrated that breast reconstruction rates have increased overtime more quickly for minority patients, and that race is associated with different types of reconstruction. PubMedPubMedCentral
29.
Zurück zum Zitat Millman M. Access to health care in America. Washington, DC: National Academic Press; 1993. Millman M. Access to health care in America. Washington, DC: National Academic Press; 1993.
30.
Zurück zum Zitat Epstein AJ, Gray BH, Schlesinger M. Racial and ethnic differences in the use of high-volume hospitals and surgeons. Arch Surg. 2010;145(2):179–86.PubMed Epstein AJ, Gray BH, Schlesinger M. Racial and ethnic differences in the use of high-volume hospitals and surgeons. Arch Surg. 2010;145(2):179–86.PubMed
31.
Zurück zum Zitat Campbell JE, Janitz AE, Vesely SK, Lloyd D, Pate A. Patterns of care for localized breast cancer in Oklahoma, 2003-2006. Women Health. 2015;55(8):975–95.PubMedPubMedCentral Campbell JE, Janitz AE, Vesely SK, Lloyd D, Pate A. Patterns of care for localized breast cancer in Oklahoma, 2003-2006. Women Health. 2015;55(8):975–95.PubMedPubMedCentral
32.
Zurück zum Zitat Churilla TM, Egleston B, Bleicher R, Dong Y, Meyer J, Anderson P. Disparities in the local management of breast cancer in the US according to health insurance status. Breast J. 2017;23(2):169–76.PubMed Churilla TM, Egleston B, Bleicher R, Dong Y, Meyer J, Anderson P. Disparities in the local management of breast cancer in the US according to health insurance status. Breast J. 2017;23(2):169–76.PubMed
33.
Zurück zum Zitat Nguyen BC, Alawadi ZM, Roife D, Kao LS, Ko TC, Wray CJ. Do socioeconomic factors and race determine the likelihood of breast-conserving surgery? Clin Breast Cancer. 2016;16(4):e93–7.PubMed Nguyen BC, Alawadi ZM, Roife D, Kao LS, Ko TC, Wray CJ. Do socioeconomic factors and race determine the likelihood of breast-conserving surgery? Clin Breast Cancer. 2016;16(4):e93–7.PubMed
34.
Zurück zum Zitat Silber JH, Rosenbaum PR, Clark AS, Giantonio BJ, Ross RN, Teng Y, et al. Characteristics associated with differences in survival among black and white women with breast cancer. JAMA. 2013;310(4):389–97.PubMed Silber JH, Rosenbaum PR, Clark AS, Giantonio BJ, Ross RN, Teng Y, et al. Characteristics associated with differences in survival among black and white women with breast cancer. JAMA. 2013;310(4):389–97.PubMed
35.
Zurück zum Zitat Mosunjac M, Park J, Strauss A, Birdsong G, Du V, Rizzo M, et al. Time to treatment for patients receiving BCS in a public and a private university hospital in Atlanta. Breast J. 2012;18(2):163–7.PubMed Mosunjac M, Park J, Strauss A, Birdsong G, Du V, Rizzo M, et al. Time to treatment for patients receiving BCS in a public and a private university hospital in Atlanta. Breast J. 2012;18(2):163–7.PubMed
36.
Zurück zum Zitat Bustami RT, Shulkin DB, O'Donnell N, Whitman ED. Variations in time to receiving first surgical treatment for breast cancer as a function of racial/ethnic background: a cohort study. JRSM Open. 2014;5(7):2042533313515863.PubMedPubMedCentral Bustami RT, Shulkin DB, O'Donnell N, Whitman ED. Variations in time to receiving first surgical treatment for breast cancer as a function of racial/ethnic background: a cohort study. JRSM Open. 2014;5(7):2042533313515863.PubMedPubMedCentral
37.
Zurück zum Zitat Keating NL, Kouri E, He Y, Weeks JC, Winer EP. Racial differences in definitive breast cancer therapy in older women: are they explained by the hospitals where patients undergo surgery? Med Care. 2009;47(7):765–73.PubMed Keating NL, Kouri E, He Y, Weeks JC, Winer EP. Racial differences in definitive breast cancer therapy in older women: are they explained by the hospitals where patients undergo surgery? Med Care. 2009;47(7):765–73.PubMed
38.
Zurück zum Zitat Popescu I, Schrag D, Ang A, Wong M. Racial/ethnic and socioeconomic differences in colorectal and breast cancer treatment quality: the role of physician-level variations in care. Med Care. 2016;54(8):780–8.PubMedPubMedCentral Popescu I, Schrag D, Ang A, Wong M. Racial/ethnic and socioeconomic differences in colorectal and breast cancer treatment quality: the role of physician-level variations in care. Med Care. 2016;54(8):780–8.PubMedPubMedCentral
39.
Zurück zum Zitat Esnaola NF, Knott K, Finney C, Gebregziabher M, Ford ME. Urban/rural residence moderates effect of race on receipt of surgery in patients with nonmetastatic breast cancer: a report from the South Carolina central cancer registry. Ann Surg Oncol. 2008;15(7):1828–36.PubMedPubMedCentral Esnaola NF, Knott K, Finney C, Gebregziabher M, Ford ME. Urban/rural residence moderates effect of race on receipt of surgery in patients with nonmetastatic breast cancer: a report from the South Carolina central cancer registry. Ann Surg Oncol. 2008;15(7):1828–36.PubMedPubMedCentral
40.
Zurück zum Zitat Olaya W, Wong JH, Morgan JW, Roy-Chowdhury S, Lum SS. Disparities in the surgical management of women with stage I breast cancer. Am Surg. 2009;75(10):869–72.PubMed Olaya W, Wong JH, Morgan JW, Roy-Chowdhury S, Lum SS. Disparities in the surgical management of women with stage I breast cancer. Am Surg. 2009;75(10):869–72.PubMed
41.
Zurück zum Zitat Akinyemiju TF, Vin-Raviv N, Chavez-Yenter D, Zhao X, Budhwani H. Race/ethnicity and socio-economic differences in breast cancer surgery outcomes. Cancer Epidemiol. 2015;39(5):745–51.PubMed Akinyemiju TF, Vin-Raviv N, Chavez-Yenter D, Zhao X, Budhwani H. Race/ethnicity and socio-economic differences in breast cancer surgery outcomes. Cancer Epidemiol. 2015;39(5):745–51.PubMed
42.
Zurück zum Zitat Bauder AR, Gross CP, Killelea BK, Butler PD, Kovach SJ, Fox JP. The relationship between geographic access to plastic surgeons and breast reconstruction rates among women undergoing mastectomy for cancer. Ann Plast Surg. 2017;78(3):324–9.PubMed Bauder AR, Gross CP, Killelea BK, Butler PD, Kovach SJ, Fox JP. The relationship between geographic access to plastic surgeons and breast reconstruction rates among women undergoing mastectomy for cancer. Ann Plast Surg. 2017;78(3):324–9.PubMed
43.
Zurück zum Zitat Mahmoudi E, Giladi AM, Wu L, Chung KC. Effect of federal and state policy changes on racial/ethnic variation in immediate postmastectomy breast reconstruction. Plast Reconstr Surg. 2015;135(5):1285–94.PubMed Mahmoudi E, Giladi AM, Wu L, Chung KC. Effect of federal and state policy changes on racial/ethnic variation in immediate postmastectomy breast reconstruction. Plast Reconstr Surg. 2015;135(5):1285–94.PubMed
44.
Zurück zum Zitat Kruper L, Holt A, Xu XX, Duan L, Henderson K, Bernstein L, et al. Disparities in reconstruction rates after mastectomy: patterns of care and factors associated with the use of breast reconstruction in Southern California. Ann Surg Oncol. 2011;18(8):2158–65.PubMed Kruper L, Holt A, Xu XX, Duan L, Henderson K, Bernstein L, et al. Disparities in reconstruction rates after mastectomy: patterns of care and factors associated with the use of breast reconstruction in Southern California. Ann Surg Oncol. 2011;18(8):2158–65.PubMed
45.
Zurück zum Zitat Kruper L, Xu X, Henderson K, Bernstein L. Disparities in reconstruction rates after mastectomy for ductal carcinoma in situ (DCIS): patterns of care and factors associated with the use of breast reconstruction for DCIS compared with invasive cancer. Ann Surg Oncol. 2011;18(11):3210–9.PubMed Kruper L, Xu X, Henderson K, Bernstein L. Disparities in reconstruction rates after mastectomy for ductal carcinoma in situ (DCIS): patterns of care and factors associated with the use of breast reconstruction for DCIS compared with invasive cancer. Ann Surg Oncol. 2011;18(11):3210–9.PubMed
46.
Zurück zum Zitat Sisco M, Du H, Warner JP, Howard MA, Winchester DP, Yao K. Have we expanded the equitable delivery of postmastectomy breast reconstruction in the new millennium? Evidence from the national cancer data base. J Am Coll Surg. 2012;215(5):658–66 discussion 66.PubMed Sisco M, Du H, Warner JP, Howard MA, Winchester DP, Yao K. Have we expanded the equitable delivery of postmastectomy breast reconstruction in the new millennium? Evidence from the national cancer data base. J Am Coll Surg. 2012;215(5):658–66 discussion 66.PubMed
47.
Zurück zum Zitat Bradley CJ, Dahman B, Shickle LM, Lee W. Surgery wait times and specialty services for insured and uninsured breast cancer patients: does hospital safety net status matter? Health Serv Res. 2012;47(2):677–97.PubMed Bradley CJ, Dahman B, Shickle LM, Lee W. Surgery wait times and specialty services for insured and uninsured breast cancer patients: does hospital safety net status matter? Health Serv Res. 2012;47(2):677–97.PubMed
48.
Zurück zum Zitat Shippee TP, Kozhimannil KB, Rowan K, Virnig BA. Health insurance coverage and racial disparities in breast reconstruction after mastectomy. Womens Health Issues. 2014;24(3):e261–9.PubMedPubMedCentral Shippee TP, Kozhimannil KB, Rowan K, Virnig BA. Health insurance coverage and racial disparities in breast reconstruction after mastectomy. Womens Health Issues. 2014;24(3):e261–9.PubMedPubMedCentral
49.
Zurück zum Zitat Offodile AC, Tsai TC, Wenger JB, Guo L. Racial disparities in the type of postmastectomy reconstruction chosen. J Surg Res. 2015;195(1):368–76.PubMed Offodile AC, Tsai TC, Wenger JB, Guo L. Racial disparities in the type of postmastectomy reconstruction chosen. J Surg Res. 2015;195(1):368–76.PubMed
50.
Zurück zum Zitat Soni SE, Lee MC, Gwede CK. Disparities in use and access to postmastectomy breast reconstruction among African American women: a targeted review of the literature. Cancer Control. 2017;24(4):1073274817729053.PubMedPubMedCentral Soni SE, Lee MC, Gwede CK. Disparities in use and access to postmastectomy breast reconstruction among African American women: a targeted review of the literature. Cancer Control. 2017;24(4):1073274817729053.PubMedPubMedCentral
51.
Zurück zum Zitat Yang RL, Newman AS, Reinke CE, Lin IC, Karakousis GC, Czerniecki BJ, et al. Racial disparities in immediate breast reconstruction after mastectomy: impact of state and federal health policy changes. Ann Surg Oncol. 2013;20(2):399–406.PubMed Yang RL, Newman AS, Reinke CE, Lin IC, Karakousis GC, Czerniecki BJ, et al. Racial disparities in immediate breast reconstruction after mastectomy: impact of state and federal health policy changes. Ann Surg Oncol. 2013;20(2):399–406.PubMed
52.
Zurück zum Zitat Rubin LR, Chavez J, Alderman A, Pusic AL. ‘Use what god has given me’: difference and disparity in breast reconstruction. Psychol Health. 2013;28(10):1099–120.PubMedPubMedCentral Rubin LR, Chavez J, Alderman A, Pusic AL. ‘Use what god has given me’: difference and disparity in breast reconstruction. Psychol Health. 2013;28(10):1099–120.PubMedPubMedCentral
53.
Zurück zum Zitat Odom EB, Schmidt AC, Myckatyn TM, Buck DW. A cross-sectional study of variations in reimbursement for breast reconstruction: is a healthcare disparity on the horizon? Ann Plast Surg. 2018;80(3):282–6.PubMedPubMedCentral Odom EB, Schmidt AC, Myckatyn TM, Buck DW. A cross-sectional study of variations in reimbursement for breast reconstruction: is a healthcare disparity on the horizon? Ann Plast Surg. 2018;80(3):282–6.PubMedPubMedCentral
54.
Zurück zum Zitat Alderman AK, Hawley ST, Waljee J, Mujahid M, Morrow M, Katz SJ. Understanding the impact of breast reconstruction on the surgical decision-making process for breast cancer. Cancer. 2008;112(3):489–94.PubMed Alderman AK, Hawley ST, Waljee J, Mujahid M, Morrow M, Katz SJ. Understanding the impact of breast reconstruction on the surgical decision-making process for breast cancer. Cancer. 2008;112(3):489–94.PubMed
55.
Zurück zum Zitat Tseng JF, Kronowitz SJ, Sun CC, Perry AC, Hunt KK, Babiera GV, et al. The effect of ethnicity on immediate reconstruction rates after mastectomy for breast cancer. Cancer. 2004;101(7):1514–23.PubMed Tseng JF, Kronowitz SJ, Sun CC, Perry AC, Hunt KK, Babiera GV, et al. The effect of ethnicity on immediate reconstruction rates after mastectomy for breast cancer. Cancer. 2004;101(7):1514–23.PubMed
56.
Zurück zum Zitat Nelson JA, Nelson P, Tchou J, Serletti JM, Wu LC. The ethnic divide in breast reconstruction: a review of the current literature and directions for future research. Cancer Treat Rev. 2012;38(5):362–7.PubMed Nelson JA, Nelson P, Tchou J, Serletti JM, Wu LC. The ethnic divide in breast reconstruction: a review of the current literature and directions for future research. Cancer Treat Rev. 2012;38(5):362–7.PubMed
57.
Zurück zum Zitat Jagsi R, Abrahamse PH, Lee KL, Wallner LP, Janz NK, Hamilton AS, et al. Treatment decisions and employment of breast cancer patients: results of a population-based survey. Cancer. 2017;123(24):4791–9.PubMed Jagsi R, Abrahamse PH, Lee KL, Wallner LP, Janz NK, Hamilton AS, et al. Treatment decisions and employment of breast cancer patients: results of a population-based survey. Cancer. 2017;123(24):4791–9.PubMed
58.
Zurück zum Zitat Hershman DL, Richards CA, Kalinsky K, Wilde ET, Lu YS, Ascherman JA, et al. Influence of health insurance, hospital factors and physician volume on receipt of immediate post-mastectomy reconstruction in women with invasive and non-invasive breast cancer. Breast Cancer Res Treat. 2012;136(2):535–45.PubMedPubMedCentral Hershman DL, Richards CA, Kalinsky K, Wilde ET, Lu YS, Ascherman JA, et al. Influence of health insurance, hospital factors and physician volume on receipt of immediate post-mastectomy reconstruction in women with invasive and non-invasive breast cancer. Breast Cancer Res Treat. 2012;136(2):535–45.PubMedPubMedCentral
59.
Zurück zum Zitat •• Schumacher JR, Taylor LJ, Tucholka JL, Poore S, Eggen A, Steiman J, et al. Socioeconomic factors associated with post-mastectomy immediate reconstruction in a contemporary cohort of breast cancer survivors. Ann Surg Oncol. 2017;24(10):3017–23. This study evaluated trends in immediate reconstruction and the socioecnomic factors associated with reconstruction using the National Cancer Database. The authors found that race, income, education status, and insurance type were associated with undergoing immediate reconstruction. Lower-rates of reconstruction were associated with Medicaid status and geographical location. PubMedPubMedCentral •• Schumacher JR, Taylor LJ, Tucholka JL, Poore S, Eggen A, Steiman J, et al. Socioeconomic factors associated with post-mastectomy immediate reconstruction in a contemporary cohort of breast cancer survivors. Ann Surg Oncol. 2017;24(10):3017–23. This study evaluated trends in immediate reconstruction and the socioecnomic factors associated with reconstruction using the National Cancer Database. The authors found that race, income, education status, and insurance type were associated with undergoing immediate reconstruction. Lower-rates of reconstruction were associated with Medicaid status and geographical location. PubMedPubMedCentral
60.
Zurück zum Zitat Ballard TNS, Zhong L, Momoh AO, Chung KC, Waljee JF. Improved rates of immediate breast reconstruction at safety net hospitals. Plast Reconstr Surg. 2017;140(1):1–10.PubMed Ballard TNS, Zhong L, Momoh AO, Chung KC, Waljee JF. Improved rates of immediate breast reconstruction at safety net hospitals. Plast Reconstr Surg. 2017;140(1):1–10.PubMed
61.
Zurück zum Zitat Vora H, Chung A, Lewis A, Mirocha J, Amersi F, Giuliano A, et al. Reconstruction among patients undergoing mastectomy: the effect of surgical deserts. J Surg Res. 2018;223:237–42.PubMed Vora H, Chung A, Lewis A, Mirocha J, Amersi F, Giuliano A, et al. Reconstruction among patients undergoing mastectomy: the effect of surgical deserts. J Surg Res. 2018;223:237–42.PubMed
62.
Zurück zum Zitat Wexelman B, Schwartz JA, Lee D, Estabrook A, Ma AM. Socioeconomic and geographic differences in immediate reconstruction after mastectomy in the United States. Breast J. 2014;20(4):339–46.PubMed Wexelman B, Schwartz JA, Lee D, Estabrook A, Ma AM. Socioeconomic and geographic differences in immediate reconstruction after mastectomy in the United States. Breast J. 2014;20(4):339–46.PubMed
63.
Zurück zum Zitat • Epstein S, Tran BN, Cohen JB, Lin SJ, Singhal D, Lee BT. Racial disparities in postmastectomy breast reconstruction: national trends in utilization from 2005 to 2014. Cancer, 2018;124(13):2774–84. Using the American College of Surgeons National Surgical Quality Improvement Program database, this study described trends in racial disparities for women undergoing breast reconstruction and by reconstruction subtype. From 2005 to 2014, overall reciept of reconstruction increased, reciept of autologous reconstruction decreased, reciept of free-flap autologous increased dramatically. These trends were significant for all racial groups. In addition, the index of disparity decreased for overal reconstruction including implant-based reconstruction and free-flap reconstruction. • Epstein S, Tran BN, Cohen JB, Lin SJ, Singhal D, Lee BT. Racial disparities in postmastectomy breast reconstruction: national trends in utilization from 2005 to 2014. Cancer, 2018;124(13):2774–84. Using the American College of Surgeons National Surgical Quality Improvement Program database, this study described trends in racial disparities for women undergoing breast reconstruction and by reconstruction subtype. From 2005 to 2014, overall reciept of reconstruction increased, reciept of autologous reconstruction decreased, reciept of free-flap autologous increased dramatically. These trends were significant for all racial groups. In addition, the index of disparity decreased for overal reconstruction including implant-based reconstruction and free-flap reconstruction.
64.
Zurück zum Zitat Breast Cancer Patient Education Act of 2015, HR 2540, 114 Congress, 1st Session (2015). Breast Cancer Patient Education Act of 2015, HR 2540, 114 Congress, 1st Session (2015).
65.
Zurück zum Zitat New York State Senate. S A10094B, 2009–2010 legislative session (2010). New York State Senate. S A10094B, 2009–2010 legislative session (2010).
66.
Zurück zum Zitat • Mahmoudi E, Lu Y, Metz AK, Momoh AO, Chung KC. Association of a policy mandating physician-patient communication with racial/ethnic disparities in postmastectomy breast reconstruction. JAMA Surg. 2017;152(8):775–83. This retrospective study evaluated whether legislation mandating physician-patient communication led to reduced racial/ethnic disparities in immediate breast reconstruction. Communication was not associated with the overall reconstruction rate or the disparity between white and African American patients, however, it was associated with a reduction in disparities between Hispanic and white patients. Therefore, legislation may help address inequity in use of immediate reconstruction, but may not help certain subpopulations. PubMedPubMedCentral • Mahmoudi E, Lu Y, Metz AK, Momoh AO, Chung KC. Association of a policy mandating physician-patient communication with racial/ethnic disparities in postmastectomy breast reconstruction. JAMA Surg. 2017;152(8):775–83. This retrospective study evaluated whether legislation mandating physician-patient communication led to reduced racial/ethnic disparities in immediate breast reconstruction. Communication was not associated with the overall reconstruction rate or the disparity between white and African American patients, however, it was associated with a reduction in disparities between Hispanic and white patients. Therefore, legislation may help address inequity in use of immediate reconstruction, but may not help certain subpopulations. PubMedPubMedCentral
67.
Zurück zum Zitat Jeevan R, Mennie JC, Mohanna PN, O'Donoghue JM, Rainsbury RM, Cromwell DA. National trends and regional variation in immediate breast reconstruction rates. Br J Surg. 2016;103(9):1147–56.PubMed Jeevan R, Mennie JC, Mohanna PN, O'Donoghue JM, Rainsbury RM, Cromwell DA. National trends and regional variation in immediate breast reconstruction rates. Br J Surg. 2016;103(9):1147–56.PubMed
68.
Zurück zum Zitat Reuben BC, Manwaring J, Neumayer LA. Recent trends and predictors in immediate breast reconstruction after mastectomy in the United States. Am J Surg. 2009;198(2):237–43.PubMed Reuben BC, Manwaring J, Neumayer LA. Recent trends and predictors in immediate breast reconstruction after mastectomy in the United States. Am J Surg. 2009;198(2):237–43.PubMed
69.
Zurück zum Zitat Escribà JM, Pareja L, Esteban L, Gálvez J, Melià A, Roca L, et al. Trends in the surgical procedures of women with incident breast cancer in Catalonia, Spain, over a 7-year period (2005-2011). BMC Res Notes. 2014;7:587.PubMedPubMedCentral Escribà JM, Pareja L, Esteban L, Gálvez J, Melià A, Roca L, et al. Trends in the surgical procedures of women with incident breast cancer in Catalonia, Spain, over a 7-year period (2005-2011). BMC Res Notes. 2014;7:587.PubMedPubMedCentral
70.
Zurück zum Zitat Hvilsom GB, Hölmich LR, Frederiksen K, Steding-Jessen M, Friis S, Dalton SO. Socioeconomic position and breast reconstruction in Danish women. Acta Oncol. 2011;50(2):265–73.PubMed Hvilsom GB, Hölmich LR, Frederiksen K, Steding-Jessen M, Friis S, Dalton SO. Socioeconomic position and breast reconstruction in Danish women. Acta Oncol. 2011;50(2):265–73.PubMed
71.
Zurück zum Zitat Platt J, Zhong T, Moineddin R, Booth GL, Easson AM, Fernandes K, et al. Geographic variation immediate and delayed breast reconstruction utilization in Ontario, Canada and plastic surgeon availability: a population-based observational study. World J Surg. 2015;39(8):1909–21.PubMed Platt J, Zhong T, Moineddin R, Booth GL, Easson AM, Fernandes K, et al. Geographic variation immediate and delayed breast reconstruction utilization in Ontario, Canada and plastic surgeon availability: a population-based observational study. World J Surg. 2015;39(8):1909–21.PubMed
74.
Zurück zum Zitat Hall SE, Holman CD. Inequalities in breast cancer reconstructive surgery according to social and locational status in Western Australia. Eur J Surg Oncol. 2003;29(6):519–25.PubMed Hall SE, Holman CD. Inequalities in breast cancer reconstructive surgery according to social and locational status in Western Australia. Eur J Surg Oncol. 2003;29(6):519–25.PubMed
75.
Zurück zum Zitat Li J, Cornacchi SD, Farrokhyar F, Johnston N, Forbes S, Reid S, et al. Relation between socioeconomic variables and surgical, systemic and radiation treatment in a cohort of patients with breast cancer in an urban Canadian centre. Can J Surg. 2019;62(2):83–92.PubMedPubMedCentral Li J, Cornacchi SD, Farrokhyar F, Johnston N, Forbes S, Reid S, et al. Relation between socioeconomic variables and surgical, systemic and radiation treatment in a cohort of patients with breast cancer in an urban Canadian centre. Can J Surg. 2019;62(2):83–92.PubMedPubMedCentral
76.
Zurück zum Zitat Gorey KM, Luginaah IN, Holowaty EJ, Fung KY, Hamm C. Wait times for surgical and adjuvant radiation treatment of breast cancer in Canada and the United States: greater socioeconomic inequity in America. Clin Invest Med. 2009;32(3):E239–49.PubMedPubMedCentral Gorey KM, Luginaah IN, Holowaty EJ, Fung KY, Hamm C. Wait times for surgical and adjuvant radiation treatment of breast cancer in Canada and the United States: greater socioeconomic inequity in America. Clin Invest Med. 2009;32(3):E239–49.PubMedPubMedCentral
77.
Zurück zum Zitat Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, et al. Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: national longitudinal mortality study. Cancer Causes Control. 2009;20(4):417–35.PubMed Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, et al. Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: national longitudinal mortality study. Cancer Causes Control. 2009;20(4):417–35.PubMed
78.
Zurück zum Zitat Gorey KM, Kliewer E, Holowaty EJ, Laukkanen E, Ng EY. An international comparison of breast cancer survival: Winnipeg, Manitoba and Des Moines, Iowa, metropolitan areas. Ann Epidemiol. 2003;13(1):32–41.PubMedPubMedCentral Gorey KM, Kliewer E, Holowaty EJ, Laukkanen E, Ng EY. An international comparison of breast cancer survival: Winnipeg, Manitoba and Des Moines, Iowa, metropolitan areas. Ann Epidemiol. 2003;13(1):32–41.PubMedPubMedCentral
79.
Zurück zum Zitat Gorey KM, Holowaty EJ, Fehringer G, Laukkanen E, Richter NL, Meyer CM. An international comparison of cancer survival: metropolitan Toronto, Ontario, and Honolulu, Hawaii. Am J Public Health. 2000;90(12):1866–72.PubMedPubMedCentral Gorey KM, Holowaty EJ, Fehringer G, Laukkanen E, Richter NL, Meyer CM. An international comparison of cancer survival: metropolitan Toronto, Ontario, and Honolulu, Hawaii. Am J Public Health. 2000;90(12):1866–72.PubMedPubMedCentral
80.
Zurück zum Zitat Jeevan R, Cromwell DA, Browne JP, Trivella M, Pereira J, Caddy CM, et al. Regional variation in use of immediate breast reconstruction after mastectomy for breast cancer in England. Eur J Surg Oncol. 2010;36(8):750–5.PubMed Jeevan R, Cromwell DA, Browne JP, Trivella M, Pereira J, Caddy CM, et al. Regional variation in use of immediate breast reconstruction after mastectomy for breast cancer in England. Eur J Surg Oncol. 2010;36(8):750–5.PubMed
81.
Zurück zum Zitat Coetzee WC, Apffelstaedt JP, Zeeman T, Du Plessis M. Disparities in breast cancer: private patients have better outcomes than public patients. World J Surg. 2018;42(3):727–35.PubMed Coetzee WC, Apffelstaedt JP, Zeeman T, Du Plessis M. Disparities in breast cancer: private patients have better outcomes than public patients. World J Surg. 2018;42(3):727–35.PubMed
82.
Zurück zum Zitat Benatar SR. The challenges of health disparities in South Africa. S Afr Med J. 2013;103(3):154–5.PubMed Benatar SR. The challenges of health disparities in South Africa. S Afr Med J. 2013;103(3):154–5.PubMed
83.
Zurück zum Zitat O'Neil DS, Chen WC, Ayeni O, Nietz S, Buccimazza I, Singh U, et al. Breast cancer care quality in South Africa’s public health system: an evaluation using American Society of Clinical Oncology/National Quality Forum Measures. J Glob Oncol. 2019;5:1–16.PubMed O'Neil DS, Chen WC, Ayeni O, Nietz S, Buccimazza I, Singh U, et al. Breast cancer care quality in South Africa’s public health system: an evaluation using American Society of Clinical Oncology/National Quality Forum Measures. J Glob Oncol. 2019;5:1–16.PubMed
84.
Zurück zum Zitat Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893–917.PubMed Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893–917.PubMed
85.
Zurück zum Zitat Herbst MC. Cancer Association of South Africa (CANSA) fact sheet on the top ten cancers per population group top ten most common cancers of women top ten most common cancers of Asian men. Cansa. 2015;2015:1–6. Herbst MC. Cancer Association of South Africa (CANSA) fact sheet on the top ten cancers per population group top ten most common cancers of women top ten most common cancers of Asian men. Cansa. 2015;2015:1–6.
86.
Zurück zum Zitat Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023–75.PubMedPubMedCentral Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023–75.PubMedPubMedCentral
87.
Zurück zum Zitat Pusic AL, Matros E, Fine N, Buchel E, Gordillo GM, Hamill JB, et al. Patient-reported outcomes 1 year after immediate breast reconstruction: results of the mastectomy reconstruction outcomes consortium study. J Clin Oncol. 2017;35(22):2499–506.PubMedPubMedCentral Pusic AL, Matros E, Fine N, Buchel E, Gordillo GM, Hamill JB, et al. Patient-reported outcomes 1 year after immediate breast reconstruction: results of the mastectomy reconstruction outcomes consortium study. J Clin Oncol. 2017;35(22):2499–506.PubMedPubMedCentral
88.
Zurück zum Zitat Wilkins EG, Cederna PS, Lowery JC, Davis JA, Kim HM, Roth RS, et al. Prospective analysis of psychosocial outcomes in breast reconstruction: one-year postoperative results from the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg. 2000;106(5):1014–25 discussion 26-7.PubMed Wilkins EG, Cederna PS, Lowery JC, Davis JA, Kim HM, Roth RS, et al. Prospective analysis of psychosocial outcomes in breast reconstruction: one-year postoperative results from the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg. 2000;106(5):1014–25 discussion 26-7.PubMed
89.
Zurück zum Zitat Atisha D, Alderman AK, Lowery JC, Kuhn LE, Davis J, Wilkins EG. Prospective analysis of long-term psychosocial outcomes in breast reconstruction: two-year postoperative results from the Michigan Breast Reconstruction Outcomes Study. Ann Surg. 2008;247(6):1019–28.PubMed Atisha D, Alderman AK, Lowery JC, Kuhn LE, Davis J, Wilkins EG. Prospective analysis of long-term psychosocial outcomes in breast reconstruction: two-year postoperative results from the Michigan Breast Reconstruction Outcomes Study. Ann Surg. 2008;247(6):1019–28.PubMed
90.
Zurück zum Zitat Rowland JH, Desmond KA, Meyerowitz BE, Belin TR, Wyatt GE, Ganz PA. Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J Natl Cancer Inst. 2000;92(17):1422–9.PubMed Rowland JH, Desmond KA, Meyerowitz BE, Belin TR, Wyatt GE, Ganz PA. Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J Natl Cancer Inst. 2000;92(17):1422–9.PubMed
91.
Zurück zum Zitat Al-Ghazal SK, Fallowfield L, Blamey RW. Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. Eur J Cancer. 2000;36(15):1938–43.PubMed Al-Ghazal SK, Fallowfield L, Blamey RW. Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. Eur J Cancer. 2000;36(15):1938–43.PubMed
Metadaten
Titel
Breast Reconstruction Disparities in the United States and Internationally
verfasst von
Sarah E. Hart
Adeyiza O. Momoh
Publikationsdatum
15.05.2020
Verlag
Springer US
Erschienen in
Current Breast Cancer Reports / Ausgabe 3/2020
Print ISSN: 1943-4588
Elektronische ISSN: 1943-4596
DOI
https://doi.org/10.1007/s12609-020-00366-z

Weitere Artikel der Ausgabe 3/2020

Current Breast Cancer Reports 3/2020 Zur Ausgabe

Breast Cancer Disparities (LA Newman, Section Editor)

Large Datasets for Disparities Research in Breast Cancer

Breast Cancer Disparities (LA Newman, Section Editor)

Breast Cancer Health Disparities in Hispanics/Latinas

Lymphedema Incidence, Prevention and Treatment (J Armer, Section Editor)

Surgical Approaches to the Prevention and Management of Breast Cancer–Related Lymphedema

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

ASS schützt nicht vor Brustkrebsrezidiven

02.05.2024 Mammakarzinom Nachrichten

Nützt nichts und ist vielleicht sogar schädlich: In einer Phase-3-Studie konnten täglich 300 mg ASS keine Brustkrebsrezidive bei Frauen vermeiden, die ein hohes Risiko für eine Tumorrückkehr aufwiesen. Tendenziell traten unter ASS sogar häufiger Rezidive auf als unter Placebo.

CUP-Syndrom: Künstliche Intelligenz kann Primärtumor finden

30.04.2024 Künstliche Intelligenz Nachrichten

Krebserkrankungen unbekannten Ursprungs (CUP) sind eine diagnostische Herausforderung. KI-Systeme können Pathologen dabei unterstützen, zytologische Bilder zu interpretieren, um den Primärtumor zu lokalisieren.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.