Table 2.
Impact of breast reconstruction availability on odds of UM and CPM (compared to BCS), adjusted by patient, disease and geography characteristics
| Adjusted RRR CPM |
95% CI | p | Adjusted RRR UM |
95% CI | p | |
|---|---|---|---|---|---|---|
| Breast reconstruction rates | 1.07 | 1.05–1.07 | <0.01 | 0.98 | 0.97–0.98 | <0.01 |
| Age | 0.94 | 0.94–0.95 | <0.01 | 1.01 | 1.00–1.01 | <0.01 |
| Race | <0.01 | <0.01 | ||||
| African-American | 1.00 | 1.00 | ||||
| Caucasian | 2.04 | 1.99–2.10 | 1.09 | 1.08–1.11 | ||
| Asian | 1.00 | 0.95–1.06 | 1.66 | 1.62–1.70 | ||
| Hispanic | 1.80 | 1.75–1.86 | 1.14 | 1.12–1.16 | ||
| Other | 1.55 | 1.45–1.66 | 1.21 | 1.17–1.25 | ||
| Charlson comorbidity score | <0.01 | <0.01 | ||||
| 0 | 1.00 | 1.00 | ||||
| ≥1 | 1.36 | 1.33–1.40 | 1.34 | 1.32–1.35 | ||
| Zip code median income | <0.01 | <0.01 | ||||
| <$30,000 | 1.00 | 1.00 | ||||
| $31,000–34,999 | 1.06 | 1.03–1.09 | 0.95 | 0.93–0.96 | ||
| $35,000–45,999 | 0.99 | 0.96–1.02 | 0.91 | 0.89–0.92 | ||
| $46,000+ | 0.97 | 0.94–1.00 | 0.85 | 0.84–0.87 | ||
| Zip code population without high school diploma | ||||||
| <0.01 | <0.01 | |||||
| 29%+ | 1.00 | 1.00 | ||||
| 20.0–28.9% | 1.14 | 1.11–1.17 | 0.94 | 0.93–0.95 | ||
| 14.0–19.9 | 1.17 | 1.14–1.20 | 0.91 | 0.89–0.92 | ||
| <14.0% | 1.33 | 1.29–1.36 | 0.89 | 0.88–0.90 | ||
| Health insurance | <0.01 | <0.01 | ||||
| Private | 1.00 | 1.00 | ||||
| Medicaid | 0.69 | 0.66–0.71 | 1.26 | 1.24–1.29 | ||
| Medicare | 0.98 | 0.96–1.00 | 1.25 | 1.23–1.26 | ||
| Other public | 0.98 | 0.92–1.04 | 1.09 | 1.05–1.13 | ||
| Uninsured | 0.73 | 0.68–0.76 | 1.26 | 1.18–1.24 | ||
| Urban vs. rural residence | <0.01 | <0.01 | ||||
| Urban | 1.00 | 1.00 | ||||
| Rural | 1.24 | 1.18–1.31 | 1.18 | 1.15–1.21 | ||
| Facility location | <0.01 | <0.01 | ||||
| Northeast | 1.00 | 1.00 | ||||
| South | 1.90 | 1.87–1.94 | 1.49 | 1.48–1.51 | ||
| Midwest | 1.55 | 1.52–1.58 | 1.35 | 1.34–1.37 | ||
| West | 1.60 | 1.57–1.64 | 1.14 | 1.12–1.15 | ||
| Tumor size (T) | <0.01 | <0.01 | ||||
| T0 (DCIS) | 1.00 | 1.00 | ||||
| T1 (<2 cm) | 0.47 | 0.44–0.51 | 0.48 | 0.46–0.50 | ||
| T2 (2–4.9 cm) | 0.72 | 0.66–0.78 | 1.01 | 0.96–1.04 | ||
| T3 (>5 cm) | 2.48 | 2.25–2.72 | 4.39 | 4.15–4.65 | ||
| Positive lymph nodes | <0.01 | <0.01 | ||||
| N0 (None) | 1.00 | 1.00 | ||||
| N1 (1–3) | 1.42 | 1.40–1.44 | 1.67 | 1.66–1.69 | ||
| Tumor grade | <0.01 | <0.01 | ||||
| Well differentiated | 1.00 | 1.00 | ||||
| Moderately differentiated | 1.18 | 1.16–1.20 | 1.24 | 1.23–1.26 | ||
| Poorly differentiated | 1.33 | 1.31–1.36 | 1.40 | 1.38–1.41 | ||
| Undifferentiated | 1.48 | 1.40–1.57 | 1.56 | 1.52–1.61 | ||
| Carcinoma invasion | <0.01 | <0.01 | ||||
| DCIS | 1.00 | 1.00 | ||||
| Invasive | 1.38 | 1.26–1.47 | 1.46 | 1.39–1.52 | ||
| Lobular histology | <0.01 | <0.01 | ||||
| No | 1.00 | 1.00 | ||||
| Yes | 1.83 | 1.80–1.86 | 1.30 | 1.29–1.31 | ||
Notes
RRR: Relative risk ratio, 95% CI: 95% Confidence interval
RRRs estimated in multinomial regression, with all characteristics included as predictors.