title: National trends and complication rates after bilateral mastectomy and immediate breast reconstruction from 2005 to 2012.
abstract: BACKGROUND
  This study's purpose was to examine the national rate of breast cancer patients undergoing bilateral mastectomy (BM) and immediate breast reconstruction (IBR) and their associated complication rates.
  
  
  METHODS
  Using the National Surgical Quality Improvement Program database, breast cancer patients undergoing mastectomy between 2005 and 2012 were identified. Rates in BM and IBR as well as associated complication rates were evaluated. Logistic regression was used to identify predictors of BM, IBR, and complications.
  
  
  RESULTS
  A total of 56,905 breast cancer patients underwent mastectomy. The rate of BM tripled (9.14% vs 25.44%, P < .0001) and the rate of IBR increased by 50% (29.73% vs 44.68%, P < .0001). Complication rates were higher in patients undergoing BM compared with unilateral mastectomy (11.49% vs 9.52%, P < .0001) and in patients undergoing IBR compared with mastectomy alone (11.62% vs 8.91%, P < .0001). White race and age less than 40 years were predictors of patients undergoing BM and IBR.
  
  
  CONCLUSIONS
  The rates of BM and associated IBR have increased significantly since 2005 despite higher complication rates. Further research is needed to understand the reasons for these trends.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Utah, School of Medicine, 30 N 1900 E, 3B400, Salt Lake City, UT 84132, USA.
authors.forename: Alvin C
authors.initials: AC
authors.lastname: Kwok
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Utah, School of Medicine, 30 N 1900 E, 3B400, Salt Lake City, UT 84132, USA.
authors.forename: Isak A
authors.initials: IA
authors.lastname: Goodwin
authors.affiliation: Division of Epidemiology, Department of Family and Preventative Medicine, University of Utah, School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84108, USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Ying
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Utah, School of Medicine, 30 N 1900 E, 3B400, Salt Lake City, UT 84132, USA. Electronic address: jay.agarwal@hsc.utah.edu.
authors.forename: Jayant P
authors.initials: JP
authors.lastname: Agarwal
mesh_terms: D000367:Age Factors; D001943:Breast Neoplasms / Q000601:surgery*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016015:Logistic Models; D016462:Mammaplasty / Q000706:statistics & numerical data / Q000639:trends*; D008408:Mastectomy / Q000706:statistics & numerical data / Q000639:trends*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D044469:Racial Groups; D014481:United States / Q000453:epidemiology
keywords: Bilateral mastectomy; Breast cancer; Immediate breast reconstruction