Persistent and interdependent: Racial disparities and their mechanisms in postmastectomy breast reconstruction

Jonathan Burke, Orli Friedman-Eldar, Gili Halfteck, Iago de Castro Silva, Camille C. Baumrucker, Fernando Valle Reyes, Anne Sophie Lessard, Wrood Kassira, Dido Franceschi, Susan B. Kesmodel, Eli Avisar, Neha Goel, Mecker G. Möller

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Racial disparities in accessing postmastectomy breast reconstruction persist despite expansion of insurance coverage. An updated examination with a broad assessment of mediating factors in a “majority minority” community is needed. Methods: Data were collected on all patients undergoing mastectomy for breast cancer from 2011 to 2019 in a private academic center and adjacent safety-net hospital. Multivariable logistic regression was used to assess the effect of race on postmastectomy breast reconstruction, controlling for predetermined potentially mediating and confounding variables. Results: Of 1,554 patients, 63.8% (n = 203) of non-Hispanic White, 33.4% (n = 102) of Black, and 47.9% (n = 438) of Hispanic patients underwent postmastectomy breast reconstruction. Multivariable logistic regression showed that Black patients (odds ratio [OR] 3.6, 95% confidence internal [CI]: 2.2–5.9; P < .0001) undergo significantly less postmastectomy breast reconstruction than White patients. Age, insurance status, stage, and hospital type mediated this relationship. Conclusion: Black patients have substantially reduced rates of postmastectomy breast reconstruction compared with White patients, which is mediated by socioeconomic factors.

Original languageEnglish (US)
JournalSurgery (United States)
DOIs
StateAccepted/In press - 2022
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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