The study by Nirmal Dayaratna, Dr Chu Luan Nguyen, Associate Professor Cindy Mak, Associate Professor Sanjay Warrier and Dr Joseph Dusseldorp included patients who underwent mastectomy with or without reconstruction for invasive or in situ breast carcinoma from 2010 to 2019 in Australia and New Zealand.
Key findings include:
– 42,279 women underwent mastectomy between 2010 and 2019.
– The national BR rate over the 10-year study period was 21.46 per cent.
– The yearly rate had steadily increased from 12.84 per cent in 2010 to 29.01 per cent in 2019.
– All states and territories, except South Australia and the NT, showed a steady increase in BR rate from 2010 to 2019.
– The BR rate increased from 22 per cent to 41 per cent in Victoria, 9 per cent to 33 per cent in NSW, 8 per cent to 20 per cent in QLD, and 22 per cent to 28 per cent in WA over the 10-year study period.
– SA has had a relatively low BR throughout the 10-year study period with a BR rate of 8 per cent identified in 2019.
– BR was found to be significantly more common in younger women, being most common between the ages of 40 to 54 and falling sharply from age 70 onwards.
– The majority of BR was performed in private hospitals, except in SA, where more of the procedures occurred in the public setting over the 10-year study period.
– 74 per cent of BR cases in NSW were performed in a private hospital in 2019.
– 69 per cent of BR cases in WA were performed in a private hospital in 2019.
– 51 per cent of BR cases in VIC were performed in a private hospital in 2019.
– 52 per cent of BR cases in QLD were performed in a private hospital in 2019.
– Women living in metropolitan areas had a BR rate of 33 per cent and this rate falls sharply in regional and rural areas
– Hospitals in rural and remote areas have a lower breast reconstruction rate compared to metropolitan areas.
Dr Dusseldorp, a Royal Australasian College of Surgeons Fellow and Plastic and Reconstructive Surgeon at Chris O’Brien Lifehouse in Sydney said BR following mastectomy has proven, positive quality-of-life benefits.
“The rise in uptake over the past decade is encouraging, however, there is ongoing need to address the barriers to equitable access to BR,” Dr Dusseldorp said.
“The rise in BR following mastectomy since 2010 is patient driven.
“There is a better understanding of the surgery, greater acceptance of the procedure and improved access to support groups. There are also more trained Oncoplastic Breast surgeons.
“It’s important to acknowledge not every woman wants BR following a mastectomy, however, without analysis and knowing what the trends are, it would be impossible to make informed decisions about the allocation of health services and funding.”
Dr Dusseldorp and his team’s research will be unveiled at the the Royal Australasian College of Surgeons Annual Scientific Congress in Brisbane (2-6 May).
The Congress is the largest multi-disciplinary surgical meeting held in the southern hemisphere and brings together some of the top surgical and medical minds from across New Zealand, Australia, and the rest of the world.
