Association between age and access to immediate breast reconstruction in women undergoing mastectomy for breast cancer

Show simple item record

dc.contributor.author Jeevan, R.
dc.contributor.author Browne, John P.
dc.contributor.author Gulliver-Clarke, C.
dc.contributor.author Pereira, J.
dc.contributor.author Caddy, Christopher M.
dc.contributor.author van der Meulen, J. H. P.
dc.contributor.author Cromwell, David A.
dc.date.accessioned 2018-04-30T08:27:46Z
dc.date.available 2018-04-30T08:27:46Z
dc.date.issued 2017-02-08
dc.identifier.citation Jeevan, R., Browne, J. P., Gulliver-Clarke, C., Pereira, J., Caddy, C. M., van der Meulen, J. H. P. and Cromwell, D. A. (2017) 'Association between age and access to immediate breast reconstruction in women undergoing mastectomy for breast cancer', British Journal of Surgery, 104(5), pp. 555-561. doi:10.1002/bjs.10453 en
dc.identifier.volume 104 en
dc.identifier.issued 5 en
dc.identifier.startpage 555 en
dc.identifier.endpage 561 en
dc.identifier.issn 0007-1323
dc.identifier.issn 1365-2168
dc.identifier.uri http://hdl.handle.net/10468/5901
dc.identifier.doi 10.1002/bjs.10453
dc.description.abstract Background: National guidelines state that patients with breast cancer undergoing mastectomy in England should be offered immediate breast reconstruction (IR), unless precluded by their fitness for surgery or the need for adjuvant therapies. Methods: A national study investigated factors that influenced clinicians' decision to offer IR, and collected data on case mix, operative procedures and reconstructive decision‐making among women with breast cancer having a mastectomy with or without IR in the English National Health Service between 1 January 2008 and 31 March 2009. Multivariable logistic regression was used to examine the relationship between whether or not women were offered IR and their characteristics (tumour burden, functional status, planned radiotherapy, planned chemotherapy, perioperative fitness, obesity, smoking status and age). Results: Of 13 225 women, 6458 (48·8 per cent) were offered IR. Among factors the guidelines highlighted as relevant to decision‐making, the three most strongly associated with the likelihood of an offer were tumour burden, planned radiotherapy and performance status. Depending on the combination of their values, the probability of an IR offer ranged from 7·4 to 85·1 per cent. A regression model that included all available factors discriminated well between whether or not women were offered IR (c‐statistic 0·773), but revealed that increasing age was associated with a fall in the probability of an IR offer beyond that expected from older patients' tumour and co‐morbidity characteristics. Conclusion: Clinicians are broadly following guidance on the offer of IR, except with respect to patients' age. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons, Inc. en
dc.rights © 2017, BJS Society Ltd. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Jeevan, R., Browne, J. P., Gulliver-Clarke, C., Pereira, J., Caddy, C. M., van der Meulen, J. H. P. and Cromwell, D. A. (2017) 'Association between age and access to immediate breast reconstruction in women undergoing mastectomy for breast cancer', British Journal of Surgery, 104(5), pp. 555-561, which has been published in final form at https://doi.org/10.1002/bjs.10453. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. en
dc.subject Immediate breast reconstruction en
dc.subject Reconstructive decision-making en
dc.subject Multivariable logistic regression en
dc.subject Tumour burden en
dc.subject Planned radiotherapy en
dc.subject Performance status en
dc.title Association between age and access to immediate breast reconstruction in women undergoing mastectomy for breast cancer en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother John Patrick Browne, Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: j.browne@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2018-04-27T12:01:23Z
dc.description.version Accepted Version en
dc.internal.rssid 435466847
dc.contributor.funder HQUIP, Healthcare Quality Improvement Partnership Ltd, UK
dc.description.status Peer reviewed en
dc.identifier.journaltitle British Journal of Surgery en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress J.Browne@ucc.ie en


Files in this item

This item appears in the following Collection(s)

Show simple item record

This website uses cookies. By using this website, you consent to the use of cookies in accordance with the UCC Privacy and Cookies Statement. For more information about cookies and how you can disable them, visit our Privacy and Cookies statement