A COMPARISON OF RESOURCE COSTS OF IMMEDIATE AND DELAYED BREAST RECONSTRUCTION

The resource cost (cost to our hospital) of providing mastectomy plus breast reconstruction was calculated for 276 patients who had received both mastectomy and breast reconstruction at our institution. All pat ients had completed the entire reconstructive process, including recon struction of the nipple. The resource costs of providing mastectomy wi th immediate breast reconstruction were compared with those of mastect omy with subsequent delayed reconstruction. We found that the mean res ource cost for the 57 patients who had separate mastectomy followed by delayed breast reconstruction ($28,843) was 62 percent higher than th at of mastectomy with immediate reconstruction ($17,801; n = 219, P < 0.001). Similar differences were found when patients were subgrouped b y type of reconstruction (TRAM versus tissue expansion and implants), by laterality (unilateral versus bilateral), and by history of preoper ative irradiation. We conclude that mastectomy with immediate breast r econstruction is significantly less expensive than mastectomy followed by delayed reconstruction and can potentially conserve resources.