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Current National Trends in Breast Reconstruction, Based on the Latest Timeframe of the Nationwide Inpatient Sample Database (NIS 2008- 2012) in 171,428 Patients.
Paul MA, MD, Koolen PG, MD, Ibrahim AM, MD, PhD, Kamali P, MD, Shah J, BA, Medin C, Buck DB, MD, Shermerhorn ML, MD, Lee BT, MD, MPH, MBA, Lin SJ, MD
Harvard-Research
2015-03-15
Presenter: Marek Paul
Affidavit:
Yes
Director Name: Samuel J Lin
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background
The incidence of breast cancer cases increased from 182,460 cases in 2008 to 232,670 new cases in 2012. Hence, breast reconstructive procedures follow this trend constituted both by autologous and implant based reconstructions. This study aims to assess the incidence of autologous and implant based reconstructive procedures in order to capture and identify the most up-to-date national trend.
Methods
As the HCUP Nationwide Inpatient Sample database (2008-2012) was available, a retrospective review of all patients undergoing autologous or implant based procedures was performed. Moreover, subgroup analysis was done to assess trends in the incidence of pedicled and free flap reconstructions (LD flaps, pedicled TRAM flaps, free TRAM flaps, DIEP flaps, SIEA flaps and GAP). Furthermore, reconstruction trends were plotted and regional trends, patient demographics, patient comorbidities and complications determined.
Results
Amidst analyzed cohort included in our study, 129,747 (75,7%) underwent expander/implant-based reconstructions, which remains the most frequently performed procedure. The most prevalent flap used in autologous breast reconstructive procedures nationwide, is DIEP flap (n=14,176; 34.0%) (Fig. 1). In addition there was a decreasing trend in pTRAM. The most prevalent payer (75.3%)for the autologous reconstructions was Private Insurer.
Conclusion
Epidemiologic analysis of implant-based and autologous breast reconstructions identifies the most important procedural, geographical and patient characteristics. DIEP breast reconstruction predominates as a method, which uses the autologous flap. Accordingly some of the pedicled flaps, as pTRAM are on decrease.
