Abstract A126: Rural-urban differences in breast reconstruction utilization following mastectomy

Abstract

Abstract Background: Healthcare disparities in rural women are well-defined, however little is known about breast reconstruction (BR) utilization in this population, especially rural Kentucky. The goal of this study was to determine if disparities in BR exist among post-mastectomy rural female patients in Kentucky. Methods: The Kentucky Cancer Registry was used to identify patients diagnosed with breast cancer and treated with mastectomy from 2006-2015. Patients were subdivided into mastectomy-only and mastectomy plus BR groups. 2013 Beale codes were used to stratify patients according to urban, near-metro or rural status. Chi-square tests were used to examine the association of BR along the rural-urban continuum. A multivariate logistic regression model controlling for patient, disease and treatment factors was used to predict BR. The likelihood of undergoing BR was reported in odds ratios (OR) using a 95% confidence interval (CI). Results: Overall, 12,036 patients underwent mastectomy. Of these patients, 2,822 (23.4%) also underwent BR. The rate of BR among urban, near-metro and rural patients was 32.4%, 23.1% and 14.7%, respectively. Multivariate analysis revealed that women from near metro (OR 0.56, CI 0.50-0.63; p < 0.001) and rural areas (OR 0.38, CI 0.33-0.43; p <0.001) were less likely to undergo BR than women from urban areas. Conclusion: Although BR benefits are well documented, women from rural areas undergo BR at lower rates and are less likely to receive BR than their urban and near-metro counterparts. While multiple factors contribute to this disparity, future efforts should seek to improve comprehensive breast cancer care which includes access to a reconstructive breast surgeon. Citation Format: Robert-Marlo F. Bautista, Ryan C. DeCoster, Jack C. Burns, Robert W. Edmunds, Adam J. Dugan, Brian J. Rinker, Matthew Webster, Henry C. Vasconez. Rural-urban differences in breast reconstruction utilization following mastectomy [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A126.