Login
- Titel:
Racial disparities in surgical outcomes after mastectomy in 223 000 female breast cancer patients: a retrospective cohort study.
- Dokumenttyp:
- Journal Article
- Autor(en):
- Knoedler, Samuel; Kauke-Navarro, Martin; Knoedler, Leonard; Friedrich, Sarah; Matar, Dany Y; Diatta, Fortunay; Mookerjee, Vikram G; Ayyala, Haripriya; Wu, Mengfan; Kim, Bong-Sung; Machens, Hans-Guenther; Pomahac, Bohdan; Orgill, Dennis P; Broer, P Niclas; Panayi, Adriana C
- Abstract:
- BACKGROUND: Breast cancer mortality and treatment differ across racial groups. It remains unclear whether such disparities are also reflected in perioperative outcomes of breast cancer patients undergoing mastectomy. STUDY DESIGN: The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008-2021) to identify female patients who underwent mastectomy for oncological purposes. The outcomes were stratified by five racial groups (white, Black/African American, Asian, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander) and included 30-day mortality, reoperation, readmission, surgical and medical complications, and non-home discharge. RESULTS: The study population included 222 947 patients, 68% ( n =151 522) of whom were white, 11% ( n =23 987) Black/African American, 5% ( n =11 217) Asian, 0.5% ( n =1198) American Indian/Alaska Native, and 0.5% ( n =1018) Native Hawaiian/Pacific Islander. While 136 690 (61%) patients underwent partial mastectomy, 54 490 (24%) and 31 767 (14%) women received simple and radical mastectomy, respectively. Overall, adverse events occurred in 17 222 (7.7%) patients, the largest portion of which were surgical complications ( n =7246; 3.3%). Multivariable analysis revealed that being of Asian race was protective against perioperative complications [odds ratio (OR)=0.71; P <0.001], whereas American Indian/Alaska Native women were most vulnerable to the complication occurrence (OR=1.41; P <0.001). Black/African American patients had a significantly lower risk of medical (OR=0.59; P <0.001) and surgical complications (OR=0.60; P <0.001) after partial and radical mastectomy, respectively, their likelihood of readmission (OR=1.14; P =0.045) following partial mastectomy was significantly increased. CONCLUSION: The authors identified American Indian/Alaska Native women as particularly vulnerable to complications following mastectomy. Asian patients experienced the lowest rate of complications in the perioperative period. The authors' analyses revealed comparable confounder-adjusted outcomes following partial and complete mastectomy between Black and white races. Their findings call for care equalization in the field of breast cancer surgery.
- Zeitschriftentitel:
- Int J Surg
- Jahr:
- 2024
- Band / Volume:
- 110
- Heft / Issue:
- 2
- Seitenangaben Beitrag:
- 684-699
- Volltext / DOI:
- doi:10.1097/JS9.0000000000000909
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/38052017
- Print-ISSN:
- 1743-9191
- TUM Einrichtung:
- Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)
BibTeX