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Reconstruction becoming more common after mastectomy.

The rate of breast reconstruction surgery for mastectomy increased 62% from 2009 to 2014, while the mastectomy rate itself "remained relatively stable," according to the Agency for Healthcare Research and Quality.

The rate of breast reconstructions in hospitals and ambulatory surgery settings rose steadily over the 6-year period, going from 21.7 per 100,000 women in 2009 to 35.1 per 100,000 in 2014. Meanwhile, the mastectomy rate dipped from 90.1 in 2009 to 83.2 in 2010 but varied less than 10% over the 2009-2014 time period, reaching 88.4 per 100,000 women in 2014. In a different context, the ratio of reconstructions to mastectomies went from 24-to-100 in 2009 to 40-to-100 in 2014, the AHRQ reported in a Statistical Brief.

The change in the rate of breast reconstruction was a result of increasing separation from the original procedure. In 2009, the split between women who underwent mastectomy with or without simultaneous reconstruction was 39.1% to 60.9%, but by 2014 the rates had changed to 29% with simultaneous reconstruction and 71% who received it during a separate visit or stay. "The growth in total reconstructions over this time period was entirely due to nonsimultaneous reconstructions," the AHRQ investigators wrote.

Those nonsimultaneous procedures were taking place much more often in ambulatory settings by 2014, as the rate of reconstructions at a separate visit increased 152% from 7.4 per 100,000 women in 2009 to 18.2. Simultaneous reconstructions in ambulatory settings were less common but increased at an even greater rate of 155%, going from 1.1 to 2.8 per 100,000 women. Inpatient reconstruction had little or no growth over the 6 years: Separate-visit procedures went from 6 to 6.8 and simultaneous reconstructions actually dropped from 7.4 per 100,000 women to 7.3, they reported.

The analysis was based on data from AHRQ State Inpatient Databases and State Ambulatory Surgery and Services Databases for 22 states that include 59% of the U.S. population: California, Colorado, Connecticut, Florida, Georgia, Indiana, Iowa, Maryland, Michigan, Minnesota, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, South Carolina, South Dakota, Tennessee, Utah, Vermont, and Wisconsin.

Caption: Mastectomy and breast reconstruction rates, 2009-2014

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Title Annotation:BREAST CANCER
Author:Franki, Richard
Publication:OB GYN News
Date:Nov 1, 2017
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