Barriers to breast reconstruction after mastectomy in Nova Scotia.
Bibliographic record
Abstract
BACKGROUND: Breast reconstruction after mastectomy is associated with social, psychological and physical benefits. Barriers to breast reconstruction in the United States include age, stage of disease, socioeconomic status and geographic location; however, little is known about the effects of these factors in the Canadian context of a universal health care system. We sought to determine the rate of breast reconstruction in Nova Scotia, identify characteristics influencing access to the procedure and describe the rates of different reconstructive options. METHODS: We conducted a retrospective cohort study involving all women in Nova Scotia who received diagnoses of breast cancer and had mastectomies between 1991 and 2001. We linked data from 2 administrative databases and performed analyses for each year in the study period. We followed the women until the end of the study period (2001). We used logistic regression to evaluate potential barriers to reconstruction. RESULTS: A total of 3717 women had mastectomies during the 10-year study period; of these women, 142 (3.8%) had breast reconstruction. The reconstruction rate increased to more than 5% in 3 of the last 4 years. Factors affecting the rate of breast reconstruction included patient age, stage of disease and year of mastectomy. Household income did not significantly affect the likelihood of women seeking breast reconstruction. CONCLUSION: The rate of breast reconstruction in Nova Scotia (3.8%) is considerably lower than rates reported in the United States (8%-45%). The fact that household income did not influence the breast reconstruction rate may reflect the universal nature of Canada's public health care system.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".