title: Effective breast reconstruction in female veterans.
abstract: BACKGROUND
  Despite increasing female veteran numbers, literature regarding reconstruction after breast cancer is lacking. The purpose of this study was to examine breast reconstruction referral rates and reconstruction outcomes at a tertiary Veterans Affairs hospital.
  
  
  METHODS
  Female breast cancer patients (1997-2008) were identified. Demographics, tumor stage, oncologic therapies, reconstructive timings and procedures, and complications were noted.
  
  
  RESULTS
  Eighty-two women underwent mastectomy (46%) or breast conservation (43%). The referral rates to plastic surgery were 61% (mastectomy) and 32% (overall). Reconstruction rates were 42% (mastectomy) and 22% (overall). Sixty-nine percent were suitable candidates and chose immediate (67%) or delayed (33%) reconstruction, with implant-based (44%), autologous (39%), or autologous plus implants (17%). There were complications (28%) but no mortalities. Comorbidities were not correlated with outcomes.
  
  
  CONCLUSIONS
  Breast reconstruction can be effectively delivered within the Veterans Affairs system. It is essential that sufficient Veterans Affairs resources be deployed to address the increasing reconstructive needs of female veterans.
authors.affiliation: Section of Plastic Surgery, Michael E DeBakey Veterans Affairs Medical Center, Houston, TX, USA. mimi.leong@va.gov
authors.forename: Mimi
authors.initials: M
authors.lastname: Leong
authors.forename: Chuma J
authors.initials: CJ
authors.lastname: Chike-Obi
authors.forename: C Bob
authors.initials: CB
authors.lastname: Basu
authors.forename: Edward I
authors.initials: EI
authors.lastname: Lee
authors.forename: Daniel
authors.initials: D
authors.lastname: Albo
authors.forename: David T
authors.initials: DT
authors.lastname: Netscher
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008408:Mastectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013524:Surgical Flaps; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*