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Implications of Demographics and Socioeconomic Factors in Breast Cancer Reconstruction

Zahedi, Sanam MD*; Colvill, Kayla MD*; Lopez, Mariela MD; Phillips, Linda G. MD

doi: 10.1097/SAP.0000000000001919
Breast Surgery

Background Not all women undergo breast reconstruction despite its vital role in the recovery process. Previous studies have reported that women who are ethnically diverse and of lower socioeconomic status are less likely to undergo breast reconstruction, but the reasons remain unclear. The purpose of this study is to evaluate the demographic characteristics of our patient population and their primary reason for not undergoing breast reconstruction.

Methods An institutional review board-approved, single-institution study was designed to evaluate all female breast cancer patients of all stages who underwent mastectomy but did not undergo breast reconstruction from 2008 to 2014. Patients were contacted via telephone and asked to participate in a validated, prompted survey. Data regarding their demographic information and primary reason for not undergoing breast reconstruction were collected.

Results Inclusion criteria were met by 181 patients, of which 61% participated in the survey. Overall, the most common reason for not undergoing breast reconstruction (26%) was unwillingness to undergo further procedures. However, the most common reason for patients that identified as Hispanic, Spanish-speaking, high school graduates, or having an annual income less than US $25,000 (P < 0.05) was insufficient information received.

Conclusions This study demonstrates that ethnicity and socioeconomic factors play a key role in determining why patients forego breast reconstruction. Ethnicity, language, education, income, and employment status are associated with patients not receiving appropriate education regarding their reconstructive options. Breast surgeons with a diverse patient population should ensure that these patients are adequately educated regarding their options, and if perhaps, more of these patients would decide to partake in the reconstruction process.

From the *Division of General Surgery, Department of Surgery, University of Texas Medical Branch, Galveston

Center for Reconstructive Surgery, Department of Plastic Surgery, University of Texas, MD Anderson Cancer Center, Houston

Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX.

Received October 25, 2018, and accepted for publication, after revision February 1, 2019.

Conflicts of interest and sources of funding: none declared.

Reprints: Linda G. Phillips, MD, Division of Plastic Surgery, Department of Surgery University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0724. E-mail:

Online date: June 21, 2019

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