• Rachel Xue Ning Lee, Maria Joao Cardoso, Kwok Leung Cheung, and Ruth M Parks.
• Nottingham Breast Cancer Research Centre, University of Nottingham, Nottingham, UK.
• Br J Surg. 2022 Oct 14; 109 (11): 106310721063-1072.

BackgroundPostmastectomy immediate breast reconstruction (PMIBR) may improve the quality of life of patients with breast cancer, of whom older women (aged 65 years or more) are a growing proportion. This study aimed to assess PMIBR in older women with regard to underlying impediments (if any).MethodsMEDLINE, Embase, and PubMed were searched by two independent researchers up to June 2022. Eligible studies compared PMIBR rates between younger and older women with invasive primary breast cancer.ResultsA total of 10 studies (2012-2020) including 466 134 women were appraised, of whom two-thirds (313 298) were younger and one-third (152 836) older. Only 10.0 per cent of older women underwent PMIBR in contrast to 45.0 per cent of younger women. Two studies explored factors affecting uptake of PMIBR in older women; surgeon-associated (usual practice), patient-associated (socioeconomic status, ethnicity, and co-morbidities), and system-associated (insurance status and hospital location) factors were identified.ConclusionUptake of PMIBR in older women is low with definable (and some correctable) barriers.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.

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