Predictors for reconstruction and mood disorder associated with reconstruction in patients with breast cancer and mastectomy: A retrospective cohort study

This study used Taiwan's National Health Insurance medical claims to investigate the predictors for operative modes chosen by early-stage breast cancer patients; as well as to assess whether operative modes are associated with risk of mood disorder. We included 36,377 patients with breast cancer who received surgery between 2000 and 2008, and were followed to the end of 2010; they were further classified into 3 groups: mastectomy alone (n=34,900), along with early reconstruction (n=1080), and along with delayed reconstruction (n=397). The results showed that age, insurance premium, urbanization level, and postsurgery chemotherapy and radiotherapy were all significant predictors for the selection of operative modes. Breast cancer patients with mastectomy alone, early reconstruction, and delayed reconstruction showed a cumulative incidence rate of mood disorder of 36.90%, 41.56%, and 33.89%, respectively. The multiple cox proportional model further revealed that early (hazard ratio [HR]=1.06, 95% confidence interval (CI)=0.93-1.21) and delayed (HR=1.17, 95% CI=0.96-1.42) reconstruction were associated with a slightly higher but insignificant risk of mood disorder, as compared to the patients received no reconstruction.