Browse > Article
http://dx.doi.org/10.5999/aps.2019.01676

Current status of and trends in post-mastectomy breast reconstruction in Korea  

Song, Woo Jin (Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine)
Kang, Sang Gue (Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine)
Kim, Eun Key (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine)
Song, Seung Yong (Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine)
Lee, Joon Seok (Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University)
Lee, Jung Ho (Department of Plastic and Reconstructive Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Jin, Ung Sik (Department of Plastic and Reconstructive Surgery, Seoul National University Hospital)
Publication Information
Archives of Plastic Surgery / v.47, no.2, 2020 , pp. 118-125 More about this Journal
Abstract
Since April 2015, post-mastectomy breast reconstruction has been covered by the Korean National Health Insurance Service (NHIS). The frequency of these procedures has increased very rapidly. We analyzed data obtained from the Big Data Hub of the Health Insurance Review and Assessment Service (HIRA) and determined annual changes in the number of breast reconstruction procedures and related trends in Korea. We evaluated the numbers of mastectomy and breast reconstruction procedures performed between April 2015 and December 2018 using data from the HIRA Big Data Hub. We determined annual changes in the numbers of total, autologous, and implant breast reconstructions after NHIS coverage commenced. Data were analyzed using Microsoft Excel. The post-mastectomy breast reconstruction rate increased from 19.4% in 2015 to 53.4% in 2018. In 2015, implant reconstruction was performed in 1,366 cases and autologous reconstruction in 905 (60.1% and 39.8%, respectively); these figures increased to 3,703 and 1,570 (70.2% and 29.7%, respectively) in 2018. Free tissue transfer and deep inferior epigastric perforator flap creation were the most common autologous reconstruction procedures. For implant-based reconstructions, the rates of directto-implant and tissue-expander breast reconstructions (first stage) were similar in 2018. This study summarizes breast reconstruction trends in Korea after NHIS coverage was expanded in 2015. A significant increase over time in the post-mastectomy breast reconstruction rate was evident, with a trend toward implant-based reconstruction. Analysis of data from the HIRA Big Data Hub can be used to predict breast reconstruction trends and convey precise information to patients and physicians.
Keywords
Breast neoplasms; Mammaplasty; Statistics; Insurance; Big data;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Jung KW, Won YJ, Kong HJ, et al. Prediction of cancer incidence and mortality in Korea, 2019. Cancer Res Treat 2019; 51:431-7.   DOI
2 Korean Breast Cancer Society. Breast cancer facts & figures 2018. Seoul: Korean Breast Cancer Society; 2018.
3 Hong KY, Son Y, Chang H, et al. Trends in breast reconstruction: implications for the National Health Insurance Service. Arch Plast Surg 2018;45:239-45.   DOI
4 Stevens LA, McGrath MH, Druss RG, et al. The psychological impact of immediate breast reconstruction for women with early breast cancer. Plast Reconstr Surg 1984;73:619-28.   DOI
5 Fung KW, Lau Y, Fielding R, et al. The impact of mastectomy, breast-conserving treatment and immediate breast reconstruction on the quality of life of Chinese women. ANZ J Surg 2001;71:202-6.   DOI
6 BreastReconstruction.org. Breast reconstruction insurance coverage [Internet]. Great Neck, NY: BreastReconstruction.org [cited 2020 Mar 9]. Available from: http://www.breastreconstruction.org/breast_reconstruction_insurance_coverage.html.
7 National Health Insurance Service (HNIS). National Health Insurance Program in Korea [Internet]. Wonju: NHIS; c2010 [cited 2018 Sep 6]. Available from: https://www.nhis.or.kr/static/html/wbd/g/a/wbdga0401.html.
8 Albornoz CR, Bach PB, Mehrara BJ, et al. A paradigm shift in U.S. breast reconstruction: increasing implant rates. Plast Reconstr Surg 2013;131:15-23.   DOI
9 Xie Y, Tang Y, Wehby GL. Federal health coverage mandates and health care utilization: the case of the Women's Health and Cancer Rights Act and use of breast reconstruction surgery. J Womens Health (Larchmt) 2015;24:655-62.   DOI
10 Alderman AK, Wei Y, Birkmeyer JD. Use of breast reconstruction after mastectomy following the Women's Health and Cancer Rights Act. JAMA 2006;295:387-8.   DOI
11 Ministry of Health and Welfare. Details on the criteria and method of application of allowance of medical care revision [Internet]. Sejong: Ministry of Health and Welfare [cited 2018 Mar 27]. Available from: http://www.mohw.go.kr/react/index.jsp.
12 Park YT, Yoon JS, Speedie SM, et al. Health insurance claim review using information technologies. Healthc Inform Res 2012;18:215-24.   DOI
13 American Society of Plastic Surgeons (ASPS). 2018 Plastic Surgery Statistics Report [Internet]. Arlington Heights, IL: ASPS; c2018 [cited 2020 Mar 9]. Available from: https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf.
14 Alderman AK, Hawley ST, Waljee J, et al. Correlates of referral practices of general surgeons to plastic surgeons for mastectomy reconstruction. Cancer 2007;109:1715-20.   DOI
15 U.S. Food and Drug Administration (FDA). Regulatory history of breast implants in the U.S. [Internet]. Silver Spring, MD: U.S. FDA [cited 2020 Mar 9]. Available from: https://www.fda.gov/medical-devices/breast-implants/update-safety-silicone-gel-filled-breast-implants-2011-executive-summary.
16 Gopie JP, Hilhorst MT, Kleijne A, et al. Women's motives to opt for either implant or DIEP-flap breast reconstruction. J Plast Reconstr Aesthet Surg 2011;64:1062-7.   DOI
17 Ho A, Cordeiro P, Disa J, et al. Long-term outcomes in breast cancer patients undergoing immediate 2-stage expander/implant reconstruction and postmastectomy radiation. Cancer 2012;118:2552-9.   DOI
18 King TA, Sakr R, Patil S, et al. Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. J Clin Oncol 2011;29:2158-64.   DOI
19 Quemener J, Wallet J, Boulanger L, et al. Decision-making determinants for breast reconstruction in women over 65 years old. Breast J 2019;25:1235-40.   DOI