National trends and regional variation in immediate breast reconstruction rates R. Jeevan* 1,4, J.C. Mennie* 1,2, P.-N. Mohanna2, J.M. O’Donoghue5, R.M. Rainsbury6, D.A. Cromwell 1,3 1Clinical Effectiveness Unit, The Royal College of Surgeons of England, 2Department of Plastic and Reconstructive Surgery, Guy’s and St Thomas’ NHS Foundation Trust, 3Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, 4Department of Plastic Surgery, Hey Children’s NHS Foundation Trust, Liverpool, 5Department of Plastic and Reconstructive Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne 6Department of Plastic Surgery, Hampshire Hospitals NHS Foundation Royal Hampshire County Hospital, Winchester, UK Mr R. Jeevan, Clinical Effectiveness Unit, The Royal College of Surgeons of England, Correspondence to: Lincoln’s Inn Fields, London WC2A 3PE, UK (e-mail: ). * Joint first authors ABSTRACT Background: Previous studies have identified variation in immediate reconstruction (IR) rates following mastectomy for breast cancer across English regions during a period of service reorganization, a national audit and changing guidelines. This study analyses current variations in regional rates of IR in England. Methods: Patient-level data from Hospital Episode Statistics was used to define a cohort of female patients who underwent primary mastectomy for invasive or breast carcinoma in English in situ National Health Service (NHS) hospitals between April 2000 and March 2014. A time series of IR rates was calculated nationally and within regions in 28 cancer networks. Regional IR rates before and
National trends and regional variation in immediate breast reconstruction rates R. Jeevan* 1,4, J.C. Mennie* 1,2, P.-N. Mohanna2, J.M. O’Donoghue5, R.M. Rainsbury6, D.A. Cromwell 1,3 1Clinical Effectiveness Unit, The Royal College of Surgeons of England, 2Department of Plastic and Reconstructive Surgery, Guy’s and St Thomas’ NHS Foundation Trust, 3Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, 4Department of Plastic Surgery, Hey Children’s NHS Foundation Trust, Liverpool, 5Department of Plastic and Reconstructive Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne 6Department of Plastic Surgery, Hampshire Hospitals NHS Foundation Royal Hampshire County Hospital, Winchester, UK Correspondence to: Mr R. Jeevan, Clinical Effectiveness Unit, The Royal College of Surgeons of England, Lincoln’s Inn Fields, London WC2A 3PE, UK (e-mail: ). * Joint first authors ABSTRACT Background: Previous studies have identified variation in immediate reconstruction (IR) rates following mastectomy for breast cancer across English regions during a period of service reorganization, a national audit and changing guidelines. This study analyses current variations in regional rates of IR in England. Methods: Patient-level data from Hospital Episode Statistics was used to define a cohort of female patients who underwent primary mastectomy for invasive or in situ breast carcinoma in English National Health Service (NHS) hospitals between April 2000 and March 2014. A time series of IR rates was calculated nationally and within regions in 28 cancer networks. Regional IR rates before and
Jeevan_MBR_ClinicalDecisions_AcceptedBJS.docx