ABS ePoster Library

Introduction: Ethnicity associated variation in primary cancer biology has been documented. However, despite adjusting for covariates such as age and disease stage, ethnicity is hypothesised to play a role in mastectomy and reconstruction rates. In this study we look at how ethnicity affects these rates as well as requests for contralateral surgery.

Methods: All patients who underwent mastectomy between November 2014 to March 2016 were identified from electronic computer records. Ethnicity as entered by the patient at time of admission was recorded. Individual patient records were reviewed to document whether patients were suitable for breast conserving surgery but had undergone mastectomy out of choice. Suitability for reconstruction was documented and if suitable, what type of reconstruction they had chosen if any. Contralateral mastectomy rates out of patient choice was also documented.

Results: In the study period 99 patients had a mastectomy. The cohort comprised of 60% Caucasian, 17% Black, 8 % Asian and 15% who had not stated an ethnicity. There was no significant difference in the number of patients suitable for reconstruction in each group (P<0.05). Caucasian women had the highest reconstruction rates (74%) followed by Black (61.5%) with Asian women having the lowest rates (50%). Contralateral mastectomy rates out of patient choice was highest in the black population (23.5%) compared with 15% in the Caucasian and nil in the Asian population.

Conclusions: The ethnic disparity in mastectomy and breast reconstruction is complicated. The decision making process is affected by multiple factors including cultural and religious values as well as language skills. Understanding these factors will aid trusts with high ethnic populations to address the disparities in uptake of breast reconstruction whilst respecting patient values.