Background: Despite its benefits in body image, self-esteem, sexuality, and quality of life, historically fewer than 25 percent patients undergo immediate breast reconstruction. After passage the Women Health Cancer Rights Act, studies failed to demonstrate changes reconstructive rates. A recent single-year report suggests significant shifts U.S. reconstruction patterns. The authors' goal was assess long-term trends rates types Methods: serial cross-sectional study performed using Nationwide...

Purpose The goals of immediate postmastectomy breast reconstruction are to minimize deformity and optimize quality life as perceived by patients. We prospectively evaluated patient-reported outcomes (PROs) in women undergoing implant-based or autologous reconstruction. Methods Women for invasive cancer and/or carcinoma situ were enrolled at 11 sites. underwent tissue Patients completed the BREAST-Q, a condition-specific PRO measure surgery patients, Patient-Reported Outcomes Measurement...

Background: The aims of the current study were to (1) measure trends in type mastectomy performed, (2) evaluate sociodemographic/hospital characteristics patients undergoing contralateral prophylactic versus unilateral mastectomies, and (3) analyze reconstruction rates method used following different types. Methods: Mastectomies from 1998 2008 analyzed using Nationwide Inpatient Sample database. (n = 178,603) classified as either unilateral, prophylactic, or bilateral prophylactic....

Background: Postmastectomy radiotherapy is increasingly common for patients with advanced breast cancer. The optimal timing and sequence of mastectomy, reconstruction, remains unresolved choosing immediate two-stage prosthetic reconstruction. Methods: Long-term outcomes were compared all prosthetic-based reconstruction without radiation, radiation to the tissue expander, or permanent implant from 2003 2012 performed by senior author (P.G.C.). Surgeon-evaluated included reconstructive...

Background: Postmastectomy radiation therapy is increasingly indicated in patients with node-positive breast cancer. The authors prospectively evaluated long-term outcomes two-stage implant-based reconstruction and postmastectomy to the permanent implant. Methods: A cohort of 1415 operated on by a single surgeon from 1998 2010 was annually. Outcomes were recorded prospectively. Complication rates compared between irradiated nonirradiated implants, including reconstructive failure (implant...

Reimbursement has been recognized as a physician barrier to autologous reconstruction. Autologous reconstructions are more expensive than prosthetic reconstructions, but provide greater health-related quality of life. The authors' hypothesis is that tissue cost-effective compared with techniques when considering life and patient satisfaction.A cost-effectiveness analysis from the payer perspective, including input, was performed for unilateral bilateral deep inferior epigastric perforator...

Although breast-conserving surgery is oncologically safe for women with early-stage breast cancer, mastectomy rates are increasing. The objective of this study was to examine the role reconstruction in surgical management unilateral cancer.A retrospective cohort diagnosed cancer (1998 2011) identified National Cancer Data Base conducted. Rates surgery, and bilateral contralateral prophylactic procedures (per 1000 cases) were measured relation reconstruction. association between treatment...

Background: Microsurgical breast reconstruction has gained popularity because of associations with decreased abdominal morbidity and high satisfaction. Nationwide use these procedures is unknown. Although many factors can influence the method reconstruction, sociodemographic hospital characteristics have not been specifically evaluated. The authors studied importance microsurgical flaps among techniques available for evaluated effect on technique chosen. Methods: A cross-sectional study...

Background: Inadequate access to breast reconstruction was a motivating factor underlying passage of the Women’s Health and Cancer Rights Act. It remains unclear whether all patients interested in undergo this procedure. The aim study determine geographic disparities are present that limit rate method postmastectomy reconstruction. Methods: Travel distance miles between patient’s residence hospital reporting case used as quantitative measure disparities. American College Surgeons National...

The volume-outcome relationship has not been specifically measured for U.S. autologous breast reconstruction. authors studied whether there is a between hospital procedural volume and perioperative complication rates.The identified (1) patients who underwent total mastectomy with immediate reconstruction from 1998 to 2010 (2) subset of microsurgical cases 2008 2010. Hospitals were categorized into quartiles based on number yearly procedures. Outcomes included surgery-specific systemic...

Background Immediate breast reconstruction (IBR) is often deferred, when postmastectomy radiotherapy (PMRT) anticipated, due to high complication rates. Nonetheless, because of robust data supporting improved health-related quality life associated with reconstruction, physicians and patients may be more accepting tradeoffs. The current study explores national trends IBR utilization rates methods in the setting PMRT, using National Cancer Database (NCDB). hypothesis that prosthetic techniques...

Background Existing patient‐reported outcome measures (PROMs) used to assess patients with head and neck cancer have methodologic content deficiencies. Herein, the development of a PROM that meets range clinical research needs across oncology is described. Methods After conceptual framework, which involved literature review, semistructured patient interviews, expert input, who were treated at Memorial Sloan Kettering Cancer Center recruited by their surgeon. The FACE‐Q Head Neck Module was...

Background: A consensus is lacking on a uniform reconstructive algorithm for patients with locally advanced breast cancer who require postmastectomy radiotherapy. Both delayed autologous and immediate prosthetic techniques have inherent advantages complications. The study hypothesis that implants are more cost effective than reconstruction in the setting of radiotherapy because restoration mound. Methods: cost-effectiveness analysis model using payer perspective was created comparing against...

There is increased clinical use of computer-assisted design (CAD) and modeling (CAM) for osseous flap reconstruction, particularly in the head neck region. Limited information exists about methods to optimize application this new technology cases which it may be advantageous over existing shaping. A consecutive series reconstructions planned with CAD/CAM past 5 years was analyzed. Conceptual considerations refinements process were evaluated. total 48 performed using CAD/CAM. The majority...

Background: Recent trends in U.S. breast oncology and autologous reconstruction, such as greater use of contralateral prophylactic mastectomies microsurgery, may have increased reconstructive complication rates costs. Simultaneously, with the complexity reconstruction setting declining reimbursement, there be market concentration these procedures to specialized high-volume centers. This study aimed (1) measure cost microsurgical technique, mastectomies, centers; (2) analyze share procedures....

Background: The rise in U.S. immediate breast reconstruction over the past decade may reflect greater patient awareness or expanding use women not previously offered reconstruction. purpose of current study was to determine whether high-risk surgical and oncologic patients a factor contributing increased rates, specifically using prosthetic techniques. Methods: Information from cohort mastectomy 2001 2012 extracted an institutional database, including presence features (age 60 years old,...

The supraclavicular artery island flap (SAIF) has recently been repopularized as a versatile and reliable option for reconstruction of oncological head neck defects. Prior ipsilateral dissection or irradiation is considered relative contraindication to its use. aim this study was describe the safety utility SAIF in setting radiation.A retrospective chart review performed consecutive reconstructions at two institutions between May 2011 2014. In addition demographic data, comorbidities,...

<b>Background</b> Free jejunal transfer for pharyngoesophageal reconstruction has often been criticized its associated donor-site morbidity. Conversely, the same argument invoked to support use of fasciocutaneous flaps, given their low incidence complications. The purpose current study was document complication rate with free flaps reconstruction, in hands an experienced surgeon. <b>Methods</b> A retrospective chart review performed consecutive patients who underwent between 1992 and 2012 by...