Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patients

Abstract Background and objectives Immediate postmastectomy breast reconstruction (IPBR) has gained wide popularity in China. We sought to clarify the prevalence and predictors of implant‐based vs autologous IPBR among Chinese patients. Methods A retrospective cohort study was performed using a pros...

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Main Authors: Zhuming Yin, Yan Wang, Jingyan Sun, Qingfeng Huang, Jing Liu, Shanshan He, Chunyong Han, Shu Wang, Bowen Ding, Jian Yin
Format: Article
Language:English
Published: Wiley 2019-05-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.2133
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author Zhuming Yin
Yan Wang
Jingyan Sun
Qingfeng Huang
Jing Liu
Shanshan He
Chunyong Han
Shu Wang
Bowen Ding
Jian Yin
author_facet Zhuming Yin
Yan Wang
Jingyan Sun
Qingfeng Huang
Jing Liu
Shanshan He
Chunyong Han
Shu Wang
Bowen Ding
Jian Yin
author_sort Zhuming Yin
collection DOAJ
description Abstract Background and objectives Immediate postmastectomy breast reconstruction (IPBR) has gained wide popularity in China. We sought to clarify the prevalence and predictors of implant‐based vs autologous IPBR among Chinese patients. Methods A retrospective cohort study was performed using a prospectively maintained database. Women who underwent IPBR during 2001‐2017 were included. The modality‐specific trends were deciphered by curve fitting analysis. The association of sociodemographic and oncological features with the decision for implant‐based vs autologous IPBR was investigated using multivariate logistic regression and structural equation modeling. Results Among 905 patients included in the study, 479 underwent implant‐based IPBR and 426 underwent autologous procedures. The implant/autologous ratio has increased exponentially over time. Multivariate analysis demonstrated that unmarried patients with BMI ≤ 24 kg/m2, earlier clinical tumor stage, and preoperative pathological diagnosis of noninvasive lesion are more likely to choose implant‐based IPBR compared to autologous procedures. The indirect effects of age, mastectomy type, and neoadjuvant chemotherapy were further demonstrated by the structural equations. Conclusions The sociodemographic and oncological features are directly or indirectly associated with the decision on type of IPBR. The findings may facilitate both patients and physicians to make a high‐quality decision by holistic evaluation of the sociodemographic and oncological features.
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spelling doaj-art-a4d202573c104c3c84b997ea86a2306f2024-11-15T13:01:04ZengWileyCancer Medicine2045-76342019-05-01852223223210.1002/cam4.2133Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patientsZhuming Yin0Yan Wang1Jingyan Sun2Qingfeng Huang3Jing Liu4Shanshan He5Chunyong Han6Shu Wang7Bowen Ding8Jian Yin9Department of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Breast Oncoplastic Surgery Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaAbstract Background and objectives Immediate postmastectomy breast reconstruction (IPBR) has gained wide popularity in China. We sought to clarify the prevalence and predictors of implant‐based vs autologous IPBR among Chinese patients. Methods A retrospective cohort study was performed using a prospectively maintained database. Women who underwent IPBR during 2001‐2017 were included. The modality‐specific trends were deciphered by curve fitting analysis. The association of sociodemographic and oncological features with the decision for implant‐based vs autologous IPBR was investigated using multivariate logistic regression and structural equation modeling. Results Among 905 patients included in the study, 479 underwent implant‐based IPBR and 426 underwent autologous procedures. The implant/autologous ratio has increased exponentially over time. Multivariate analysis demonstrated that unmarried patients with BMI ≤ 24 kg/m2, earlier clinical tumor stage, and preoperative pathological diagnosis of noninvasive lesion are more likely to choose implant‐based IPBR compared to autologous procedures. The indirect effects of age, mastectomy type, and neoadjuvant chemotherapy were further demonstrated by the structural equations. Conclusions The sociodemographic and oncological features are directly or indirectly associated with the decision on type of IPBR. The findings may facilitate both patients and physicians to make a high‐quality decision by holistic evaluation of the sociodemographic and oncological features.https://doi.org/10.1002/cam4.2133breast cancerdecision‐makingimmediate breast reconstructiononcological featuressociodemographic characteristics
spellingShingle Zhuming Yin
Yan Wang
Jingyan Sun
Qingfeng Huang
Jing Liu
Shanshan He
Chunyong Han
Shu Wang
Bowen Ding
Jian Yin
Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patients
Cancer Medicine
breast cancer
decision‐making
immediate breast reconstruction
oncological features
sociodemographic characteristics
title Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patients
title_full Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patients
title_fullStr Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patients
title_full_unstemmed Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patients
title_short Association of sociodemographic and oncological features with decision on implant‐based versus autologous immediate postmastectomy breast reconstruction in Chinese patients
title_sort association of sociodemographic and oncological features with decision on implant based versus autologous immediate postmastectomy breast reconstruction in chinese patients
topic breast cancer
decision‐making
immediate breast reconstruction
oncological features
sociodemographic characteristics
url https://doi.org/10.1002/cam4.2133
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