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2010 Annual Meeting Abstracts

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National and Maine State Trends in Breast Reconstruction After Surgery for Breast Cancer
*Anne Kieryn1, Lisa Rutstein1, *Therese White2
1Maine Medical Center, Portland, ME;2Plastic and Hand Surgical Associates, South Portland, ME

Compare Maine State data to National benchmark for breast reconstruction after mastectomy. Design:
Retrospective observational review of surgical treatment after mastectomy of breast cancer patients in Maine between 2002-2006. Setting:
37 community and academic hospitals in Maine (11 ACoS); all participate in the State Tumor Registry (Registry). Patients:
Comprehensive review of female patients with breast cancer included in the Registry from 2002-2006 (7815 patients). Patients who had mastectomies were selected for study inclusion. Interventions:
Breast reconstruction after mastectomy. Patients were not chosen at random to receive reconstruction; surgical intervention after mastectomy was selected by surgeon and/or patient. Results of reconstruction decisions were recorded in the Registry; hospital and patient Registry data are blinded to individual hospital, but not ACS-determined regions. Registry data were retrieved; analysis compared women post-mastectomy who did and did not have reconstructive surgery. Results were stratified by region Main Outcome Measures:
Rate of breast reconstruction after mastectomy as function of region in which patients received surgical intervention. State and regional data were compared to national benchmarks. Results:
The national rate of breast reconstruction after mastectomy in 2006 was 75%. In Maine, 533 mastectomies were performed in 2006; 127 had reconstruction, giving the State of Maine a rate of 24%. Reconstruction rates differed significantly by region. Conclusions:
Maine falls below the national average for breast reconstruction after mastectomy. We hypothesize this discrepancy is due to regional availability of immediate reconstruction and reluctance of community hospitals to transfer patients to tertiary centers. Further studies are needed to understand other factors affecting surgical decision making for breast cancer patients.

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