caa a22 4500 445339071 CHVBK 20180317142806.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-2010-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-2010-y Disparities in Reconstruction Rates after Mastectomy for Ductal Carcinoma in Situ (DCIS): Patterns of Care and Factors Associated with the Use of Breast Reconstruction for DCIS Compared with Invasive Cancer [Elektronische Daten] [Laura Kruper, Xinxin Xu, Katherine Henderson, Leslie Bernstein] Background: Many factors influence whether breast cancer patients undergo reconstruction after mastectomy. This study was undertaken to determine the patterns of care and variables associated with the use of reconstruction for ductal carcinoma in situ (DCIS) and to compare previous results for invasive carcinoma. Methods: Postmastectomy reconstruction rates were collected from the California Office of Statewide Health Planning and Development (OSHPD) for 2003-2007. International Classification of Disease-9 codes were used to identify patients undergoing reconstruction after mastectomy. Variations in reconstruction rates were examined by type of breast cancer (DCIS vs. invasive), calendar year, age, type of insurance, type of hospital, and race/ethnicity. Univariate and multivariate odds ratios (OR) with 95% confidence intervals (CI) were estimated for relative odds of immediate reconstruction versus mastectomy only. Results: For multivariate analysis, age, race/ethnicity, type of insurance, and type of hospital were significantly associated with the use of reconstruction for DCIS patients. DCIS patients were twice as likely to undergo reconstruction as patients with invasive cancer (odds ratio (OR)=1.93, 95% confidence interval (CI)=1.75-2.13). DCIS patients with private insurance were nine times more likely to undergo reconstruction as patients with Medicaid (OR=8.84, 95% CI=5.92-13.21). Both Hispanic white and Asian patients were one-fifth as likely to undergo reconstruction compared with non-Hispanic white patients (OR=0.18, 95% CI=0.1-0.3; OR=0.17, 95% CI=0.09-0.31). Conclusions: Postmastectomy rates for DCIS were twice those for invasive cancer mostly because stage was not a limiting factor. However, significant factors remain that limit the use of reconstruction in this breast cancer population: age, race/ethnicity, type of hospital, and type of insurance. Society of Surgical Oncology, 2011 Kruper Laura General and Oncologic Surgery, City of Hope, USA aut Xu Xinxin Population Sciences, City of Hope, USA aut Henderson Katherine Population Sciences, City of Hope, USA aut Bernstein Leslie Population Sciences, City of Hope, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3210-3219 1068-9265 18:11<3210 2011 18 10434 https://doi.org/10.1245/s10434-011-2010-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-2010-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kruper Laura General and Oncologic Surgery, City of Hope, USA aut NATIONALLICENCE 700 1- Xu Xinxin Population Sciences, City of Hope, USA aut NATIONALLICENCE 700 1- Henderson Katherine Population Sciences, City of Hope, USA aut NATIONALLICENCE 700 1- Bernstein Leslie Population Sciences, City of Hope, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3210-3219 1068-9265 18:11<3210 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer