Influence of Race, Income, Insurance, and Education on the Rate of Breast Reconstruction

Abstract

Background/aim: The aim of this study was to analyze how race, income, insurance, and education, affect breast reconstruction rates.

Materials and methods: We reviewed the National Cancer Database. χ² test and binary logistic regression were used to analyze the association between demographic characteristics and reconstruction rate.

Results: White race and private insurance were associated with a higher risk of getting reconstruction when compared to black race (odd ratio [OR]=0.939; 95%CI=0.909-0.970) and government insurance (OR=0.459; 95%CI=0.447-0.471). Patients with an estimated income >$63,000 were found to have higher odds of receiving breast reconstruction than patients with income less than $38,000 (OR=1.868; 95%CI=1.792-1.948). Patients who live in a zip code area with a higher education average have higher odds of receiving postmastectomy breast reconstruction than patients living in a zip code with a lower education average (OR=1.152, 95%CI=1.104-1.203).

Conclusion: Differences in reconstruction rates exist based on race, income, insurance, and education level.

Keywords: Breast neoplasms/surgery; female; healthcare disparities/statistics & numerical data; mastectomy; middle aged; retrospective studies.