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Breast Cancer Reconstruction Epidemiology

  • Joanna C. Mennie
  • Jennifer Rusby
  • David A. Cromwell
  • Richard Rainsbury
Chapter

Abstract

As breast cancer treatments have evolved, care pathways have been subject to various reforms worldwide. Specifically with regard to breast reconstruction, the psychosocial morbidity following mastectomy has been widely appreciated, and reconstruction is now regarded as an integral part of breast cancer treatment. In the last decade, evolving mastectomy approaches, refinements in reconstruction techniques, and the advent of acellular dermal matrices have all influenced practice. In this chapter, we explore trends in the uptake of post-mastectomy breast reconstruction and the type of procedures used in different countries.

Overall, an increase in immediate post-mastectomy reconstruction has been reported in numerous countries. In the delayed setting, uptake appears to have stabilised, although there is less information about patterns in individual countries. In the UK, immediate reconstruction increased from 10% in 2000 to 23% in 2013, whilst in the USA, the rate has increased to around 35%. There has also been a shift in immediate reconstruction practice from autologous to implant procedures, with implant-based reconstruction increasing from 30 to 54% (2007–2013) in the UK and from 39 to 63% (1998–2008) in the USA. Significant geographical variation in practice has been reported within countries, both in terms of uptake and procedure type. This variation suggests that the structure and process by which health care is delivered play an important role in determining the specific pathway women follow. Further, it also suggests there is potential to increase the proportion of women undergoing post-mastectomy reconstruction and to improve access to all types of reconstruction procedure.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Joanna C. Mennie
    • 1
  • Jennifer Rusby
    • 2
  • David A. Cromwell
    • 1
  • Richard Rainsbury
    • 3
  1. 1.Clinical Effectiveness Unit, Royal College of Surgeons of EnglandLondonUK
  2. 2.Department of Breast SurgeryRoyal Marsden Hospital NHS Foundation TrustLondonUK
  3. 3.Department of Breast SurgeryRoyal Hampshire County HospitalWinchesterUK

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