National trends and complication rates after bilateral mastectomy and immediate breast reconstruction from 2005 to 2012

• The rate of bilateral mastectomy in breast cancer patients undergoing mastectomy from 2005 to 2012 has nearly tripled.
• The rate of immediate breast reconstruction in breast cancer patients undergoing mastectomy from 2005 to 2012 has increased by 50%.
• Complication rates were higher in breast cancer patients undergoing bilateral mastectomy compared with unilateral mastectomy.
• Complication rates were higher in breast cancer patients undergoing immediate breast reconstruction compared with mastectomy alone.
• White race and age less than 40 years were predictors of patients undergoing bilateral mastectomy and immediate breast reconstruction.

BackgroundThis study’s purpose was to examine the national rate of breast cancer patients undergoing bilateral mastectomy (BM) and immediate breast reconstruction (IBR) and their associated complication rates.MethodsUsing the National Surgical Quality Improvement Program database, breast cancer patients undergoing mastectomy between 2005 and 2012 were identified. Rates in BM and IBR as well as associated complication rates were evaluated. Logistic regression was used to identify predictors of BM, IBR, and complications.ResultsA total of 56,905 breast cancer patients underwent mastectomy. The rate of BM tripled (9.14% vs 25.44%, P < .0001) and the rate of IBR increased by 50% (29.73% vs 44.68%, P < .0001). Complication rates were higher in patients undergoing BM compared with unilateral mastectomy (11.49% vs 9.52%, P < .0001) and in patients undergoing IBR compared with mastectomy alone (11.62% vs 8.91%, P < .0001). White race and age less than 40 years were predictors of patients undergoing BM and IBR.ConclusionsThe rates of BM and associated IBR have increased significantly since 2005 despite higher complication rates. Further research is needed to understand the reasons for these trends.