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. 2022 Nov;30(4):317-323.
doi: 10.1177/22925503211055525. Epub 2021 Dec 6.

Racial Disparity in Immediate Breast Reconstruction; a Gap That is not Closing

Mahdi Malekpour  1 , Sean Devitt  1 , Joseph DeSantis  1 , Christian Kauffman  1
Affiliations

Racial Disparity in Immediate Breast Reconstruction; a Gap That is not Closing

Mahdi Malekpour et al. Plast Surg (Oakv). 2022 Nov.

Abstract
in English, French

Background: Immediate breast reconstruction (IBR) is offered as part of the standard-of-care to females undergoing mastectomy. Racial disparity in IBR has been previously reported with a longstanding call for its elimination, though unknown if this goal is achieved. The aim of this study was to examine the current association between race and IBR and to investigate whether racial disparity is diminishing. Methods: Data was extracted from the National Cancer Database (NCDB) from 2004 to 2016. All variables in the database were controlled so that the comparison would be made solely between Black and White females. We also analyzed the trend in racial disparity to see if there has been a change from 2004 to 2016 after several calls for healthcare equality. Results: After propensity score matching, 69,084 White females were compared to 69,084 Black females. There was a statistically significant difference between the rate of IBR and race (23,386 [33.9%] in White females vs 20,850 [30.2%] in Black females, P-value < .001). Despite a twofold increase in the rate of IBR in both White and Black females, a persistent gap of about 4% was observed over the study period, which translates to more than 2,500 Black females not receiving IBR. Conclusions: Using the NCDB database, a racial disparity was identified for IBR between White and Black females from 2004 and 2016. Unfortunately, the gap between the groups remained constant over this 13-year period.

Historique: La reconstruction mammaire immédiate (RMI) est proposée dans le cadre des soins standards aux femmes qui subissent une mastectomie. La disparité raciale a déjà été signalée à cet égard, dont l’élimination est réclamée depuis longtemps, mais on ne sait pas si cet objectif a été réalisé. La présente étude visait à examiner l’association courante entre la race et la RMI et à examiner si la disparité raciale diminuait. Méthodologie: Les chercheurs ont extrait les données de la National Cancer Database (NCDB) entre 2004 et 2016. Ils ont contrôlé toutes les variables de la base de données pour que la comparaison porte seulement sur les femmes noires et blanches. Ils ont également analysé la tendance en matière de disparité raciale pour déterminer s’il y avait eu un changement entre 2004 et 2016, après plusieurs appels à l’égalité dans les soins de santé. Résultats: Après l’appariement des coefficients de propension, les chercheurs ont comparé 69,084 femmes blanches à 69,084 femmes noires. Il y avait une différence statistiquement significative entre le taux de RMI et la race des 23,386 femmes blanches (33.9%) et des 20,850 femmes noires (30.2%), pour une valeur P < .001. Même si le taux de RMI a doublé autant chez les femmes blanches que chez les femmes noires, les chercheurs ont observé un écart persistant d’environ 4% pendant la période de l’étude, ce qui signifie que plus de 2,500 femmes noires n’ont pas reçu de RMI. Conclusions: À l’aide de la NCDB, les chercheurs ont constaté une disparité raciale en matière de RMI chez les femmes blanches et noires entre 2004 et 2016. Malheureusement, l’écart entre les deux groupes est demeuré constant au cours de cette période de 13 ans.

Keywords: breast; cancer; disparity; race; reconstruction.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Design of the study.
Figure 2.
Figure 2.
Trend in reconstruction over the study period.
See this image and copyright information in PMC

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