Annelotte van Bommel

83 Organizational factors affect the use of immediate breast reconstruction Table 1. Hospital characteristics of the 72 responding hospitals in the Netherlands. (continued) Dutch hospitals (n=72) Number of patients Number % DCIS Invasive breast cancer %mastectomies (of all surgical excisions) Group 1 (0/30) 4 5.6 90 612 Group 2 (30/50) 49 68.1 1.275 9,505 Group 3 (50/90) 19 26.4 615 4,374 % referrals for mastectomy Group 1 (0/2.5) 17 23.6 691 4,532 Group 2 (2.5/ 5.0) 26 36.1 628 5,054 Group 3 (>5) ub=31 29 40.3 661 4,905 % referrals mastectomy+ reconstruction Group 1 (0/2.5) 46 63.9 1.419 10,162 Group 2 (2.5/ 5.0) 17 23.6 409 3,119 Group 3 (> 5.0) ub=21 9 12.5 152 1,21 # of weekly MDT Group 1 (1) 24 33.3 535 4,214 Group 2 (2) 14 19.4 374 2,661 Group 3 (>2) ub=7 9 12.5 265 2,217 Group 4 (unknown) 25 34.7 806 5,399 # of plastic surgeons / 100 diagnoses Group 1 (0/0.5) 4 5.6 43 453 Group 2 (0.5/2.5) 60 83.3 1.713 12,791 Group 3 (>2.5) ub=23 7 9.7 215 1,136 Group 4 (unknown) 1 1.4 9 111 # of breast-surgeons / 100 diagnoses Group 1 (0/1.5) 28 38.9 932 7,181 Group 2 (1.5/2.5) 35 48.6 908 6,32 Group 3 (>2.5) ub=17 9 12.5 140 990 Attendance plastic surgeon at weekly MDT Never or incidental 13 18.1 294 2,404 Yes, structural 51 70.8 1.381 10,145 Unknown 8 11.1 305 1,942 DCIS, ductal carcinoma in situ; ub, upper boundary; MDT, multidisciplinary teammeetings. On average, 41% (n=809) of the patients underwent IBR after a mastectomy for DCIS. The hospital variation in performing IBR for DCIS varied between 0 and 80%. The average rate of IBR for invasive breast cancer was 17% (n=2,435) with a hospital variation ranging from 0 to 62%. 5