Breast reconstruction in France, observational study of 140,904 cases of mastectomy for breast cancer

Ann Chir Plast Esthet. 2020 Feb;65(1):36-43. doi: 10.1016/j.anplas.2019.07.014. Epub 2019 Aug 2.

Abstract

Objectives: In France, there are few up-to-date epidemiological data on breast reconstruction after mastectomy for breast cancer. The objective of the present study was to measure immediate and delayed breast reconstruction (IBR and DBR, respectively) rates and thus the proportion of patients not benefiting from any reconstruction.

Methods: We performed an observational study by assessing data from the French nationwide discharge summary database (Programme de Médicalisation des Systèmes d'Information) for the period 2008-2014. All women having undergone a total mastectomy for breast cancer during this period were included. We then searched for reconstructive surgery during the initial or subsequent hospital stays, and recorded the time interval between mastectomy and reconstruction.

Results: Among the 140,904 mastectomies included, the IBR rate was 16.1% on average, and increased over the study period. The time interval between mastectomy and DBR was≤3 years in 92% of cases. For patients included in 2008 and 2009, the DBR rate was 17.8%, and the non-reconstruction rate was 66.4%.

Conclusion: The high proportion of women not undergoing breast reconstruction after mastectomy suggests that access to this procedure should be improved.

Keywords: Breast cancer; Breast reconstruction; Cancer du sein; Epidemiology; Mastectomie; Mastectomy; PMSI; Reconstruction mammaire; Épidémiologie.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / surgery*
  • Female
  • France
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Mammaplasty* / statistics & numerical data
  • Mastectomy* / statistics & numerical data
  • Middle Aged
  • Time Factors
  • Time-to-Treatment / statistics & numerical data