Trends in immediate postmastectomy breast reconstruction in the United Kingdom
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background: The study aimed to evaluate local and national trends in immediate breast reconstruction (IBR) using the national English administrative records, Hospital Episode Statistics. Our prediction was an increase in implant-only and free flap procedures and a decline in latissimus flap reconstructions.
Methods: Data from an oncoplastic center were interrogated to derive numbers of implant-only, autologous latissimus dorsi (LD), LD-assisted, and autologous pedicled or free flap IBR procedures performed between 2004 and 2013. Similarly, Hospital Episode Statistics data were used to quantify national trends in these procedures from 1996 to 2012 using a curve fitting analysis.
Results: National data suggest an increase in LD procedures between 1996 (n = 250) and 2002 (n = 958), a gradual rise until 2008 (n = 1398) followed by a decline until 2012 (n = 1090). As a percentage of total IBR, trends in LD flap reconstruction better fit a quadratic (R2 = 0.97) than a linear function (R2 = 0.63), confirming a proportional recent decline in LD flap procedures. Conversely, autologous (non-LD) flap reconstructions have increased (1996 = 0.44%; 2012 = 2.76%), whereas implant-only reconstructions have declined (1996 = 95.42%; 2012 = 84.92%). Locally, 70 implant-assisted LD procedures were performed in 2003 -2004, but only 2 were performed in 2012 to 2013.
Conclusions: Implants are the most common IBR technique; autologous free flap procedures have increased, and pedicled LD flap procedures are in decline.
Methods: Data from an oncoplastic center were interrogated to derive numbers of implant-only, autologous latissimus dorsi (LD), LD-assisted, and autologous pedicled or free flap IBR procedures performed between 2004 and 2013. Similarly, Hospital Episode Statistics data were used to quantify national trends in these procedures from 1996 to 2012 using a curve fitting analysis.
Results: National data suggest an increase in LD procedures between 1996 (n = 250) and 2002 (n = 958), a gradual rise until 2008 (n = 1398) followed by a decline until 2012 (n = 1090). As a percentage of total IBR, trends in LD flap reconstruction better fit a quadratic (R2 = 0.97) than a linear function (R2 = 0.63), confirming a proportional recent decline in LD flap procedures. Conversely, autologous (non-LD) flap reconstructions have increased (1996 = 0.44%; 2012 = 2.76%), whereas implant-only reconstructions have declined (1996 = 95.42%; 2012 = 84.92%). Locally, 70 implant-assisted LD procedures were performed in 2003 -2004, but only 2 were performed in 2012 to 2013.
Conclusions: Implants are the most common IBR technique; autologous free flap procedures have increased, and pedicled LD flap procedures are in decline.
Date Issued
2015-09-01
Date Acceptance
2015-07-13
Citation
Plastic and Reconstructive Surgery, Global Open, 2015, 3 (9)
ISSN
2169-7574
Publisher
Lippincott, Williams & Wilkins
Journal / Book Title
Plastic and Reconstructive Surgery, Global Open
Volume
3
Issue
9
Copyright Statement
Copyright © 2015 The Authors. Published by Wolters
Kluwer Health, Inc. on behalf of The American Society of
Plastic Surgeons. All rights reserved. This is an open-access
article distributed under the terms of the Creative Commons
Attribution-Non Commercial-No Derivatives License 4.0
(CC BY-NC-ND), where it is permissible to download and
share the work provided it is properly cited. The work cannot
be changed in any way or used commercially.
Kluwer Health, Inc. on behalf of The American Society of
Plastic Surgeons. All rights reserved. This is an open-access
article distributed under the terms of the Creative Commons
Attribution-Non Commercial-No Derivatives License 4.0
(CC BY-NC-ND), where it is permissible to download and
share the work provided it is properly cited. The work cannot
be changed in any way or used commercially.
Publication Status
Published
Article Number
e507