Recent trends in total mastectomy techniques and post-mastectomy breast cancer reconstruction: a population-based analysis

Background: In the last decade, more women are undergoing post-mastectomy reconstruction. The purpose of this study is to examine the evolving changes in mastectomy techniques and post-mastectomy reconstruction for breast cancer patients. Methods: Patients in the Surveillance, Epidemiology, and End Results (SEER) database were included from 2004 to 2014 based on a diagnosis of breast cancer using the ICD O-3 primary site codes: C50.0-50.6 and C50.8-50.9 who underwent a nipple sparing, total simple, modified radical, or radical mastectomy. Patients were categorized into 2- or 3-year cohorts based on their year of diagnosis. Results: A total of 263,161 breast cancer cases were identified. Patients tended to be middle-aged females (mean age: 59.6 years old). 35.0% of patients received a total simple mastectomy in the 2004-2005 cohort compared to 61.8% of patients in the 2012-2014 cohort (P<0.001). Regarding reconstruction technique, 14.7% of patients received post-mastectomy breast reconstruction in the 2004-2005 cohort while 31.7% received post-mastectomy breast reconstruction in the 2012-2014 cohort (P<0.001). Conclusions: Breast cancer patients who undergo mastectomies are likely to be middle-aged Caucasian females. An increased percentage of patients who receive mastectomies have lower stage disease. A higher number of patients are receiving total simple mastectomies over time as compared to modified radical mastectomies. Patients who receive a total simple mastectomy have a higher chance of receiving breast reconstruction. Finally, the use of breast implant reconstruction has increased compared to tissue reconstruction for mastectomy patients.