Effective breast reconstruction in female veterans.
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.
Leong
Mimi
M
Section of Plastic Surgery, Michael E DeBakey Veterans Affairs Medical Center, Houston, TX, USA. mimi.leong@va.gov
Chike-Obi
Chuma J
CJ
Basu
C Bob
CB
Lee
Edward I
EI
Albo
Daniel
D
Netscher
David T
DT
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*