title: A 10-year review of breast reconstruction in a university-based public hospital.
abstract: BACKGROUND
  Breast reconstruction rates continue to slowly rise in large part because of patients and physicians becoming more knowledgeable about postmastectomy options. Overall satisfaction with breast reconstruction after mastectomy has traditionally been high, only adding to the popularity of this choice. Prior research has demonstrated that race, age, and socioeconomic status are important determinants in whether a patient undergoes breast reconstruction; specifically, indigent women have a lower rate of breast reconstruction when compared to the national average.
  
  
  METHODS
  All records of patients who received mastectomies between January 2001 and December 2009 were examined. The PubMed database was used to search for reference articles.
  
  
  RESULTS
  Between January 2001 and December 2009, 309 patients underwent mastectomy, and 134 (43.4%) elected reconstruction. Patients in age ranges 20 to 39 and 40 to 59 were both significantly more likely to undergo reconstruction than patients older than 60 years. Disease stage was not significantly related to rates of breast reconstruction. Reconstruction rates by race and ethnicity were analyzed and demonstrated a significantly lower rate of breast reconstruction in Asian women (34%) compared with Hispanic women (48%), despite the same access to available services.
  
  
  CONCLUSIONS
  Our data demonstrate breast reconstruction rates significantly higher than prior studies for women in this public hospital demographic, rivaling the reported numbers from dedicated cancer centers where breast reconstruction is expected to be at the highest range. Types of reconstruction were based mainly on patient choice after full discussion regarding individual options. These data suggest that patients considered to be financially indigent are more likely to have breast reconstruction when their care is delivered at a university-based public hospital where immediate and consistent patient education is practiced in a multidisciplinary setting.
authors.affiliation: Institute of Reconstructive Plastic Surgery, Department of Plastic Surgery, New York University Langone Medical Center, New York, NY 10016, USA. steven.levine@nyumc.org
authors.forename: Steven M
authors.initials: SM
authors.lastname: Levine
authors.forename: Anne
authors.initials: A
authors.lastname: Levine
authors.forename: Javita
authors.initials: J
authors.lastname: Raghubir
authors.forename: Jamie P
authors.initials: JP
authors.lastname: Levine
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006779:Hospitals, Public; D006785:Hospitals, University; D006801:Humans; D016462:Mammaplasty / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D008408:Mastectomy; D008489:Medical Indigency; D017057:Medically Uninsured; D008875:Middle Aged; D009519:New York City; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012959:Socioeconomic Factors