Annelotte van Bommel

66 Figure 1. Funnel plot showing hospital differences in percentage of patient with invasiveM0 breast cancer treated withmastectomy and immediate breast reconstruction, unadjusted (terra squares) and adjusted for age, clinical tumor stage, clinical nodal stage, multifocality, histology, grade and receptor status (ocher triangles) (2011 – 2013). Predictive factors for immediate breast reconstruction The percentage of patients receiving IBR significantly decreasedwith increasing age. Younger patients (<50 years) had more frequent IBR [Odds Ratio (OR) 1.73; 95% Confidence Interval (95% CI) 1.58–1.91] compared to older patients (50–65 years). IBR was less often used in patients with larger tumors and patients with involved lymph nodes. Patients who were treated for a clinical T3 tumor had a three times lower chance of receiving IBR than those treated for a clinical T1 tumor (OR 0.34; 95% CI 0.28–0.41). For lymph node-positive tumors, a similar lower chance of receiving IBR was observed; a patient with a clinical N2 tumor had a three times lower chance of receiving IBR than thosewith lymph node-negative tumors (95%CI 0.17–0.65). Patients with multifocal tumors had a higher chance of receiving IBR. Being diagnosedwith a ductal carcinoma increased the chance of undergoing IBR compared to lobular carcinoma diagnosis. IBRwasmore frequently used in lower tumor grades. Hormone Receptor positive (HR+)/ HER2-positive tumors were associated with a Observed Average 95%Cl Case-mixcorrected Number of patients undergoing a mastectomy for invasive breast cancer per hospital (2011 - 2013) Percentage of patients undergoing an immediate breast reconstruction 0 100 200 300 400 500 600 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%