Abstract

Background

Breast reconstruction following mastectomy has proven benefits and is the standard of care in many high‐income countries. This audit documented regional variation in immediate breast reconstruction rates across Australia.

Methods

The Breast Surgeons of Australia and New Zealand (BreastSurgANZ) Quality Audit database and geospatial software were used to model the distribution of breast reconstructions performed on women having mastectomy in Australia in 2013. Geospatial mapping identified the distribution of these procedures in relation to the Greater Capital City Statistical Areas (GCCSAs) of the five largest states. Data were analysed using χ2 tests of independence and an independent‐samples t test.

Results

Of 3786 patients having a mastectomy, 692 underwent breast reconstruction of which 679 (98·1 per cent) were immediate reconstructions. Rates of reconstruction differed significantly between jurisdictions (χ2 = 164·90), and were significantly higher in GCCSAs (χ2 = 144·60) and private hospitals (χ2 = 50·72) (all P < 0·001). Immediate breast reconstruction was not reported for 43·8 per cent of hospitals where mastectomy was conducted by members of BreastSurgANZ, including 29·8 per cent of hospitals within GCCSAs. A wider age range of women appeared to have had immediate reconstructions at hospitals within GCCSAs, although the difference in mean age between regions was not significant. Immediate breast reconstruction was considerably less likely to be performed in women who lived in areas of lower to mid socioeconomic status.

Conclusion

Variations in the rate of immediate breast reconstruction may not be purely resource‐driven.

Details

Title
Regional variation in immediate breast reconstruction in Australia
Author
Flitcroft, K L 1   VIAFID ORCID Logo  ; Brennan, M E 1 ; Costa, D S J 2 ; Spillane, A J 3 

1  Breast and Surgical Oncology at the Poche Centre, University of Sydney, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, Australia 
2  Pain Management Research Unit, University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia 
3  Breast and Surgical Oncology at the Poche Centre, University of Sydney, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, Australia; Surgical Oncology, Breast and Endocrine Surgery Department, Mater Hospital, Sydney, Australia; Surgical Oncology, Breast and Endocrine Surgery Department, Royal North Shore Hospital, St Leonards, New South Wales, Australia 
Pages
114-121
Section
Original articles
Publication year
2017
Publication date
Nov 2017
Publisher
Oxford University Press
e-ISSN
24749842
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1002/bjs5.19
ProQuest document ID
2289587826
Copyright
© 2017. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.