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Trends in immediate postmastectomy breast reconstruction in the United Kingdom

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Title: Trends in immediate postmastectomy breast reconstruction in the United Kingdom
Authors: Leff, DR
Bottle, A
Mayer, E
Patten, D
Rao, C
Athanasiou, T
Hadjiminas, D
Darzi, A
Gui, G
Item Type: Journal Article
Abstract: 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.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.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 (R(2) = 0.97) than a linear function (R(2) = 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.Implants are the most common IBR technique; autologous free flap procedures have increased, and pedicled LD flap procedures are in decline.
Issue Date: 1-Sep-2015
Date of Acceptance: 13-Jul-2015
URI: http://hdl.handle.net/10044/1/25041
DOI: https://dx.doi.org/10.1097/GOX.0000000000000484
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.
Publication Status: Published
Article Number: e507
Appears in Collections:Division of Surgery
Faculty of Medicine



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