Influence of Facility Characteristics on Access to Breast Reconstruction: A 12-Year National Cancer Database Analysis.

BACKGROUND/AIM:This study aimed to analyze facility characteristics contributing to disparities in breast reconstruction access in the United States. PATIENTS AND METHODS:Data from January 1, 2004, to December 31, 2015 were extracted from the National Cancer Database on patient, facility and treatment, and tumor characteristics. A total of 858,594 patients met the inclusion criteria of the study, including 553,517 (64.5%) patients who underwent mastectomy only (without breast reconstruction) and 305,077 (35.5%) patients who received breast reconstruction (implants or autologous tissue). RESULTS:Multivariate analysis showed that the odds of reconstruction were higher in Integrated Network Cancer Programs and Academic/Research Programs compared to Community Cancer Programs. Patients treated in the South, Midwest, and West regions had lower odds of reconstruction. Interestingly, patients treated in more than one Commission on Cancer facility had a higher likelihood of reconstruction. CONCLUSION:Facility characteristics and location impact on access to breast reconstruction.