Racial and age disparities persist in immediate breast reconstruction: an updated analysis of 48,564 patients from the 2005 to 2011 American College of Surgeons National Surgery Quality Improvement Program data sets

BACKGROUND: Immediate breast reconstruction (IBR) rates continue to rise, yet recent patterns based on race, age, and patient comorbidities have not been adequately assessed. METHODS: Women undergoing mastectomy only or mastectomy with IBR from 2005 to 2011 were identified in the American College of Surgeons-National Surgical Quality Improvement (NSQIP) data sets. A multivariate logistic regression was performed to determine factors independently associated with receipt of IBR. Thirty-day surgical complication rates after IBR were also assessed. RESULTS: Rates of IBR increased significantly over the study period from 26% of patients in 2005 to 40% in 2011. Non-Caucasian race, older age (>= 45 years), obesity, and presence of comorbid conditions including diabetes mellitus, current smoking, and cardiovascular disease were all negatively associated with receipt of IBR. Surgical complication rates after IBR were not predicted by non-Caucasian race, older age, or presence of diabetes mellitus. CONCLUSIONS: This current assessment of IBR using the American College of Surgeons-National Surgical Quality Improvement data sets demonstrates that non-Caucasian and older women (>= 45 years) continue to receive IBR at lower rates despite the lack of association of added risk of surgical morbidity. Published by Elsevier Inc.