Disparity in Breast Cancer Female Undergoing Reconstructive Procedures: A Real-World Analysis

OBJECTIVES: With an increase in awareness about breast cancer and its treatment modalities increasing number of cancer patients have started opting for breast reconstruction. Many gaps still need to be filled in terms of inconsistency that prevail in utilizing the health care resources for patients of different ages, races, and regions. The study aimed to identify the various disparities based on age and race that exist in breast cancer patients undergoing reconstructive procedures.

METHODS: Using Optum’s de-identified Clinformatics Data Mart Database, breast cancer patients in the age group of 18 years and above, who underwent mastectomy during the index period of 1^st Jan. 2019- 31^st December 2020 were identified using ICD-10 CM diagnosis & procedure codes. These patients were then followed for 6 months to categorize them into 2 cohorts based on whether they underwent any reconstructive procedures or not. Medical costs for the two cohorts with a follow-up period of 1 year from the day of mastectomy based on age and race were analyzed.

RESULTS: Out of 70,599 eligible patients, only 4.4% of females underwent reconstructive procedures in the first 6 months post-mastectomy. Younger age group (18-29) females and Whites are significantly more likely to undergo reconstructive procedures as compared to other groups (P<0.05). The average annual medical cost per patient was significantly higher in the case of females who underwent reconstructive procedures ($12,806; P<0.001) as compared to those who did not ($3,205). Among females who underwent reconstructive procedures, the average annual medical cost was highest in the 18 to 29 age group as compared to others (P<.0001).

CONCLUSIONS: Remarkable demographic disparity could be seen among patients who underwent reconstructive procedures and who did not.