Documenting patterns of breast reconstruction in Australia: The national picture.
BACKGROUND
Differences in national health data collection systems preclude accurate assessments of how much breast reconstruction (BR) is performed in Australia. This paper aims to quantitatively document and visually map the national prevalence and distribution of BR, using the best available evidence.


METHODS
Quantitative analysis and spatial mapping of hospital-level data on BR prevalence in all six Australian states and two mainland territories. Data was extracted on 3786 women, under the care of members of Breast Surgeons of Australia and New Zealand Incorporated, who had mastectomy for breast malignancy with or without post-mastectomy BR in 2013.


RESULTS
Analysis revealed a national BR rate of 18.3%. Statistically significant differences in BR uptake (p < .0001) were found between jurisdictions [χ2(df = 7) = 284.29], with BR more likely in younger women [χ2(df = 14) = 395.62] and in private hospitals (χ2= 63.99) and less likely in remote areas [χ2(df = 4) = 66.49].


CONCLUSIONS
Analysis of this substantial subset of Australian women requiring mastectomy for breast cancer has demonstrated significant variation in provision or uptake of BR across four important variables. As BR has been shown to provide long-term survivorship benefits for the growing number of women living longer following mastectomy for breast cancer, there is an urgent need to ensure BR is accessible and affordable for all women who choose this option.
Breast & Surgical Oncology at the Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia; Northern Clinical School, University of Sydney, NSW, 2006, Australia. Electronic address: kathy.flitcroft@melanoma.org.au.
Kathy
K
Flitcroft
Breast & Surgical Oncology at the Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia; Northern Clinical School, University of Sydney, NSW, 2006, Australia. Electronic address: meagan.brennan@sydney.edu.au.
Meagan
M
Brennan
Pain Management Research Unit, University of Sydney at Royal North Shore Hospital, Reserve Rd, St Leonards, NSW, 2065, Australia. Electronic address: daniel.costa@sydney.edu.au.
Daniel
D
Costa
Breast & Surgical Oncology at the Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia; Northern Clinical School, University of Sydney, NSW, 2006, Australia; Mater Hospital, Rocklands Rd, North Sydney, NSW, 2060, Australia; Royal North Shore Hospital, Reserve Rd, St Leonards, NSW, 2065, Australia. Electronic address: andrew.spillane@melanoma.org.au.
Andrew
A
Spillane
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006801:Humans; D016462:Mammaplasty / Q000706:statistics & numerical data*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D000071836:Professional Practice Gaps / Q000706:statistics & numerical data*; D055815:Young Adult
Access to information; Breast cancer; Breast reconstruction; Data quality; Health services