National Trends in "Going Flat" After Mastectomy.
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
31
03
2022
accepted:
28
05
2023
medline:
20
9
2023
pubmed:
17
7
2023
entrez:
17
7
2023
Statut:
ppublish
Résumé
The "Going Flat" movement became widely publicized in 2016 and provides information and support to women who choose to forego post-mastectomy breast reconstruction (PMBR). The objectives of this study were to evaluate temporal trends in PMBR to ascertain the potential impact of this movement and assess which factors are associated with going flat. A retrospective cohort analysis was performed using the NCDB of women with non-metastatic breast cancer who underwent mastectomy between 2004 and 2019. Trends in going flat after mastectomy were examined and stratified by age (< 50, 50-69, ≥ 70). A multivariate logistic regression model was used to identify factors associated with going flat. 650,983 patients met the inclusion criteria: 244,201 (37.5%) underwent PMBR and 406,782 (62.5%) went flat. Among women < 70, rates of going flat steadily decreased from 2004 to 2015 and then stabilized after 2015, coinciding with the rise of the "Going Flat" movement. In multivariate analysis, non-White race, older age, increasing comorbidities, government provided insurance, treatment at a community program, radiotherapy, and adjuvant chemotherapy were associated with a higher likelihood of going flat (p < 0.001). In the first 2 years after the "Going Flat" movement, the number of women going flat after mastectomy has stabilized in women < 70 for the first time in over a decade. These trends suggest that the social and cultural impact of this movement may have contributed to the stabilization of PMBR rates.
Identifiants
pubmed: 37458947
doi: 10.1245/s10434-023-13845-1
pii: 10.1245/s10434-023-13845-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6374-6382Informations de copyright
© 2023. Society of Surgical Oncology.
Références
Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2016. Bethesda, MD: National Cancer Institute; 2019. https://seer.cancer.gov/archive/csr/1975_2017/#citation . Accessed 17 January 2022.
Albornoz CR, Cordeiro PG, Pusic AL, et al. Diminishing relative contraindications for immediate breast reconstruction: A multicenter study. J Am Coll Surg. 2014;219(4):788–95.
doi: 10.1016/j.jamcollsurg.2014.05.012
pubmed: 25159019
Seth AK, Cordeiro. Stability of long-term outcomes in implant-based breast reconstruction: An evaluation of 12-year surgeon and patient-reported outcomes in 3489 non-radiated and radiated implants. Plast Reconstr Surg. 2020;146(3):474-484.
Panchal H, Matros E. Current trends in post-mastectomy breast reconstruction. Plast Reconstr Surg. 2017;140(5):7S-13S.
doi: 10.1097/PRS.0000000000003941
pubmed: 29064917
pmcid: 5722225
Retrouvey H, Solaja O, Gagliardi AR, Webster F, Zhong T. Barriers of access to breast reconstruction: A systematic review. Plast Reconstr Surg. 2019;143(3):465–76.
doi: 10.1097/PRS.0000000000005313
Baker JL, Dizon DS, Wenziger CM, et al. “Going flat” after mastectomy: Patient-reported outcomes by online survey. Ann Surg Oncol. 2021;28(5):2493–505.
doi: 10.1245/s10434-020-09448-9
pubmed: 33393025
Morrow M, Li Y, Alderman AK, et al. Access to breast reconstruction after mastectomy and patient perspectives on reconstruction decision making. JAMA Surg. 2014;149(10):1015–21.
doi: 10.1001/jamasurg.2014.548
pubmed: 25141939
pmcid: 4732701
Rabin RC. “Going Flat” after breast cancer. The New York Times 31 October 2016. Retrieved 17 January 2022 at https://www.nytimes.com/2016/11/01/well/live/going-flat-after-breast-cancer.html Accessed 17 February 2022.
Albornoz CR, Matros E, Lee CN, et al. Bilateral mastectomy versus breast-conserving surgery for early-stage breast cancer: The role of breast reconstruction. Plast Reconstr Surg. 2015;135(6):1518–26.
doi: 10.1097/PRS.0000000000001276
pubmed: 26017588
pmcid: 4744797
Jagsi R, Jiang J, Momoh AO, 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.
doi: 10.1200/JCO.2013.52.2284
pubmed: 24550418
pmcid: 4876312
Rosenberg SM, Dominici LS, Gelber S, et al. Association of breast cancer surgery with quality of life and psychosocial well-being in young breast cancer survivors. JAMA Surg. 2020;155(11):1035–42.
doi: 10.1001/jamasurg.2020.3325
pubmed: 32936216
Not Putting on a Shirt. 2022. https://notputtingonashirt.org/ourstory/ . Accessed 16 March 2022.
Flat & Fabulous. 2022. https://www.flatandfabulous.org . Accessed 16 March 2022.
The SCAR Project. 2011. http://www.thescarproject.org . Accessed 16 March 2022.
The Breast and the Sea. 2022. https://www.thebreastandthesea.com . Accessed 16 March 2022.
Nguyen J, Thompson P, Losken A. Breast reconstruction in the social media age. Aesthet Surg J. 2021;41(2):200–5.
doi: 10.1093/asj/sjaa204
pubmed: 32667966
Maisner RS, Kapadia K, Cohen D, Ayyala HS, Lee ES. Breast reconstruction: A qualitative analysis of aesthetic and reconstructive breast surgery photographs on Instagram [published online ahead of print, 2022 Jan 19]. J Plast Reconstr Aesthet Surg. 2022 S1748-6815(22)00029-8.
Tang SYQ, Israel JS, Poore SO, Afifi AM. Facebook facts: Breast reconstruction Patient-reported outcomes using social media. Plast Reconstr Surg. 2018;141(5):1106–13.
doi: 10.1097/PRS.0000000000004275
pubmed: 29697604
Wakeley ME, Bare CF, Pine R, et al. A social media survey of women who do not pursue reconstruction after mastectomy for breast cancer: characterizing the “Going Flat” movement. Breast J. 2020;26(7):1455–7.
doi: 10.1111/tbj.13781
pubmed: 32067326
Zehra S, Doyle F, Barry M, Walsh S, Kell MR. Health-related quality of life following breast reconstruction compared to total mastectomy and breast-conserving surgery among breast cancer survivors: a systematic review and meta-analysis. Breast Cancer. 2020;27(4):534–66.
doi: 10.1007/s12282-020-01076-1
pubmed: 32162181
Metcalfe KA, Semple J, Quan ML, et al. Changes in psychosocial functioning 1 year after mastectomy alone, delayed breast reconstruction, or immediate breast reconstruction. Ann Surg Oncol. 2012;19(1):233–41.
doi: 10.1245/s10434-011-1828-7
pubmed: 21674270
Shammas RL, Fish LJ, Sergesketter AR, et al. Dissatisfaction after post-mastectomy breast reconstruction: a mixed-methods study. Ann Surg Oncol. 2022;29(2):1109–19.
doi: 10.1245/s10434-021-10720-9
pubmed: 34460034
Bennett KG, Qi J, Kim HM, Hamill JB, Pusic AL, Wilkins EG. Comparison of 2-year complication rates among common techniques for postmastectomy breast reconstruction. JAMA Surg. 2018;153(10):901–8.
doi: 10.1001/jamasurg.2018.1687
pubmed: 29926077
pmcid: 6233788
Food and Drug Administration. 2011. https://www.fda.gov/media/80685/download . Accessed 16 March 2022.
Doren EL, Miranda RN, Selber JC, et al. U.S. epidemiology of breast implant-associated anaplastic large cell lymphoma. Plast Reconstr Surg. 2017;139(5):1042–50.
doi: 10.1097/PRS.0000000000003282
pubmed: 28157769
Butler PD, Nelson JA, Fischer JP, et al. Racial and age disparities persist in immediate breast reconstruction: An updated analysis of 48,564 patients from 2005 to 2011 American College of Surgeons National Surgery Quality Improvement Program data sets. Am J Surg. 2016;212(1):96–101.
doi: 10.1016/j.amjsurg.2015.08.025
pubmed: 26545345
Cortina CS, Bergom CR, Kijack J, et al. Postmastectomy breast reconstruction in women aged 70 and older: an analysis of the National Cancer Database (NCDB). Surgery. 2021;170(1):30–8.
doi: 10.1016/j.surg.2021.03.033
pubmed: 33888316
Sada A, Day CN, Hoskin TL, et al. Mastectomy and immediate breast reconstruction in the elderly: Trends and outcomes. Surgery. 2019;166(4):709–14.
doi: 10.1016/j.surg.2019.05.055
pubmed: 31395398
Santosa KB, Qi J, Kim HM, et al. Effect of patient age on outcomes in breast reconstruction: results from a multicenter prospective study. J Am Coll Surg. 2016;223(6):745–54.
doi: 10.1016/j.jamcollsurg.2016.09.003
pubmed: 27806906
pmcid: 5124383
Albornoz CR, Bach PB, Mehara BJ, et al. A paradigm shift in U.S. breast reconstruction: Increasing implant rates. Plast Reconstr Surg. 2013;131(1):15–23.
doi: 10.1097/PRS.0b013e3182729cde
pubmed: 23271515
Yang RL, Newman AS, Lin IC, et al. Trends in immediate breast reconstruction across insurance groups after enactment of breast cancer legislation. Cancer. 2013;119(13):2462–8.
doi: 10.1002/cncr.28050
pubmed: 23585144
Lang JE, Summers DE, Cui H, et al. Trends in post-mastectomy reconstruction: A SEER database analysis. J Surg Oncol. 2013;108(3):163–8.
doi: 10.1002/jso.23365
pubmed: 23861196
pmcid: 4035023
Hu YY, Weeks CM, In H, et al. Impact of neoadjuvant chemotherapy on breast reconstruction. Cancer. 2011;117(13):2833–41.
doi: 10.1002/cncr.25872
pubmed: 21264833