Predictors of post-mastectomy breast reconstruction in Kenya

Joseph Wanjeri,Stephen Gichuru,Peter Ndaguatha,Thomas Kedera

doi:10.4314/aas.v17i1.5

Abstract

Background: Breast reconstruction following mastectomy has mental and physical health benefits. Several patient-centered factors predict the rate of breast reconstructions. We investigated the rates and predictors of breast reconstruction in postmastectomy patients diagnosed with breast cancer at a teaching and national referral center. Methods: A retrospective case-control study involving post-mastectomy females diagnosed with breast cancer from 2014 to 2018. Logistic regression evaluated potential predictors of breast reconstruction. Results: 312 women had mastectomies during the 5-year study period: 9 (2.88%) had breast reconstruction—all breast reconstructions were autologous (latissimus flap). The rate of reconstruction increased over the study period, then dropped in 2018. Factors significantly affecting the rate of breast reconstruction included patient age and insurance coverage. Conclusion: In this hospital-based study, the rate of post-mastectomy breast reconstruction is low, despite the procedure being an essential component of breast cancer care. Age and insurance coverage are predictors for breast reconstruction. Keywords: Breast reconstruction, Rates, Hospitalbased, Predictors

Highlights

Breast reconstruction (BR) brings shape to a breast it restores a woman’s identity, attractiveness and sexual desirability, and affects their quality of life [1]
Data is limited on postmastectomy breast reconstruction (PMBR) from the African countries
The primary outcome was breast reconstruction defined by these codes for implant-based reconstruction (IBR) and autologous reconstruction (AR)

Summary

Introduction

Breast reconstruction (BR) brings shape to a breast it restores a woman’s identity, attractiveness and sexual desirability, and affects their quality of life [1]. Patients experience several complications; rates of breast cancer recurrence appear not to be a direct consequence of breast reconstruction. In Kenya, no data has been published describing the limitations and rates of breast reconstruction following mastectomy. Several patient-centered factors predict the rate of breast reconstructions. We investigated the rates and predictors of breast reconstruction in postmastectomy patients diagnosed with breast cancer at a teaching and national referral center. Results: 312 women had mastectomies during the 5-year study period: 9 (2.88%) had breast reconstruction— all breast reconstructions were autologous (latissimus flap). Factors significantly affecting the rate of breast reconstruction included patient age and insurance coverage. Conclusion: In this hospital-based study, the rate of post-mastectomy breast reconstruction is low, despite the procedure being an essential component of breast cancer care.

Objectives

Methods

Findings

Conclusion