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National Trends in "Going Flat" After Mastectomy. Ann Surg Oncol 2023 Oct;30(11):6374-6382

Date

07/17/2023

Pubmed ID

37458947

DOI

10.1245/s10434-023-13845-1

Scopus ID

2-s2.0-85164942787 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

INTRODUCTION: The "Going Flat" movement became widely publicized in 2016 and provides information and support to women who choose to forego post-mastectomy breast reconstruction (PMBR). The objectives of this study were to evaluate temporal trends in PMBR to ascertain the potential impact of this movement and assess which factors are associated with going flat.

METHODS: A retrospective cohort analysis was performed using the NCDB of women with non-metastatic breast cancer who underwent mastectomy between 2004 and 2019. Trends in going flat after mastectomy were examined and stratified by age (< 50, 50-69, ≥ 70). A multivariate logistic regression model was used to identify factors associated with going flat.

RESULTS: 650,983 patients met the inclusion criteria: 244,201 (37.5%) underwent PMBR and 406,782 (62.5%) went flat. Among women < 70, rates of going flat steadily decreased from 2004 to 2015 and then stabilized after 2015, coinciding with the rise of the "Going Flat" movement. In multivariate analysis, non-White race, older age, increasing comorbidities, government provided insurance, treatment at a community program, radiotherapy, and adjuvant chemotherapy were associated with a higher likelihood of going flat (p < 0.001).

CONCLUSION: In the first 2 years after the "Going Flat" movement, the number of women going flat after mastectomy has stabilized in women < 70 for the first time in over a decade. These trends suggest that the social and cultural impact of this movement may have contributed to the stabilization of PMBR rates.

Author List

Johnson MK, Cortina CS, Hsu TL, Huang S, Frebault J, Huang CC, Kong AL

Authors

Chandler S. Cortina MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Amanda L. Kong MD, MS Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Breast Neoplasms
Cohort Studies
Female
Humans
Mammaplasty
Mastectomy
Retrospective Studies