Poster & Mini Oral Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Breast reconstruction following mastectomy in NSW, 2008-11 (#196)

Amy K Johnston 1 , Nicola Creighton 1 , David Currow 1
  1. Cancer Institute NSW, Eveleigh, NSW, Australia


To report on the use and variation in the use of immediate (IBR) and delayed breast reconstruction (DBR) among women in NSW following mastectomy for primary invasive breast cancer.


This is a population-based retrospective cohort study that used de-identified linked public and private hospital administrative data. The study cohort included all women resident in NSW, diagnosed with primary invasive breast cancer who underwent a mastectomy as their first breast resection between 2008 and 2011. IBR included procedures performed at the time of mastectomy and DBR included procedures in the 3 years following mastectomy.


Three years after a mastectomy 17% ( 969/5698) of women had a breast reconstruction. Use of IBR increased from 7.1% of women in 2008 to 11.0% in 2011. Use of DBR remained stable. Over half of women aged 18 to 39 years had BR compared with a third of 40-49 year olds. BR was rare among women aged over 70 years.

The proportion of women who underwent BR varied from 7.6 to 34.9% by Local Health District (LHD) of residence. These differences remained after adjusting for differences in age and comorbidity status. IBR was more common among residents of metropolitan (11.6%) compared with regional/rural LHDs (4.5%). Women who underwent mastectomy in a private hospital were more likely to have IBR and DBR compared with those treated in public hospitals (IBR 11.9 and 7.1%, DBR 8.7 and 6.3% respectively).


Despite BR being recognised as an important component of care following mastectomy, the proportion of women having BR remains low. Women experience age-related, geographical and financial barriers to accessing BR following mastectomy.  Variation in use of IBR is the biggest contributor to variation in BR by geography and the public/private sectors. Greater engagement of specialist plastic surgeons in multidisciplinary care is warranted.