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RESULTS: Of 45,591 SPARCS records, 20,181 women underwent immediate post mastectomy reconstruction. 15,761 (78.1%) underwent implant-based reconstruction while 4,420 (21.9%) underwent autologous reconstruction. Implants were chosen by 26% of patients in 2005, which increased to 36.4% by 2013. Flap-based reconstruction was chosen by 1% in 2005 and increased to 20.3% in 2013. Among women undergoing autologous breast reconstruction, all age groups up to the age of 75 (p<0.0005 for all groups) and all racial groups demonstrated a significant increase in reconstruction rates (p<0.0001 for white, p<0.0005 for black, p<0.0228 for Hispanic). Patients with either Medicare (p=0.0042) or Commercial (p<0.0001) insurance had significantly increased rates of autologous reconstruction with Medicare patients having the steepest increase in reconstructive rates (RR 1.45). Patients across all regions of the state had an increase in flap-based reconstruction with the steepest increases occurring upstate compared NYC, Long Island and the surrounding areas (RR 1.52 for upstate regions). Patients in all income brackets showed a significant increase in flap-based reconstructive rates (p=0.002 or less for all comparisons). Medicare patients and those age 65–74 had a significantly increased odds of having implant-based reconstruction after 2011 when compared to pre-2011 (OR 1.1 vs. 1.4). Flap-based reconstruction utilization showed a sharp increase in the pre-2011 years especially between 2008–2009 with a slower rate of increase post-2011 (OR 1.98 vs. 1.17).

Abstract P3: Readability, Complexity, and Suitability of Online Resources for Mastectomy and Lumpectomy