Racial and ethnic differences in rates of reduction mammoplasty among women with macromastia: An analysis of the All of Us Research Program.

Abstract

Reduction mammoplasty, or breast reduction, provides improvements in quality of life for women with macromastia. Existing literature has not thoroughly characterized potential socioeconomic differences in receiving breast reduction in this patient population. We explored such differences using a large multicenter patient registry. Adult female patients with macromastia were identified in the All of Us Research Program. Demographic information, including race and ethnicity, income, insurance status, and clinical information was collected for each patient. A multivariable logistic regression model was used to assess for the likelihood of receiving reduction mammoplasty. In a post-hoc analysis, incidence rates of depression and back pain were stratified by reception of reduction mammoplasty and compared (p<0.05). The final cohort included 3270 female patients with macromastia, 163 (5.0%) of whom received reduction mammoplasty. Non-Hispanic Black (OR: 0.53, 95% CI: 0.32-0.87, p=0.013) and Hispanic (OR: 0.52, 95% CI: 0.31-0.87, p=0.013) race and ethnicity predicted lower odds of reduction mammoplasty when compared to non-Hispanic White race and ethnicity. Insurance and income status were not significant predictors of receipt of reduction mammoplasty (p>0.05). Reduction mammoplasty was associated with decreased incidence rates of back pain among Hispanic, non-Hispanic Black, and non-Hispanic White cohorts. The overall incidence of reduction mammoplasty in a cohort of women with macromastia was relatively low. Race and ethnicity were associated with different rates of reduction mammoplasty. These novel findings motivate further investigation on the contributors to such differences.