SP08. Uncovering the Socioeconomic Determinants of Breast Reconstruction Outcomes Across Diverse Demographics

PURPOSE: Breast reconstruction (BR) following mastectomy is an essential part of recovery for many women with breast cancer. However, socioeconomic factors such as income and education can complicate decision-making. Prior research primarily reflects the experiences of white, educated women, often overlooking disparities faced by other demographic groups. Additionally, there is limited data exploring how specific levels of education and income impact BR rates. This study aims to examine the role of socioeconomic factors, such as income, education, social support, and access to information, in influencing BR decisions in a more diverse population. METHODS: A total of 413 women, from various socioeconomic and ethnic backgrounds, were surveyed after surgical breast cancer treatment. The survey was conducted by Kantar Lightspeed LLC in collaboration with the BRAVE Coalition. It included a 45-item questionnaire and the 13-item Satisfaction with Breasts sub-scale of the BREAST-Q, focusing on socioeconomic factors (income, education, social support, and access to information) and their relationship to the decision to undergo BR. Statistical analyses were performed using chi-square tests, Cramer’s V, and odds ratios. RESULTS: Highly significant associations were found between education and income and BR decision (p<0.01 and p<0.001, respectively). Women with a graduate degree were >3 times as likely to have BR than high school-educated women (OR=3.18, 95% CI=1.52-6.98, p<0.01), and those earning over $99,999 annually were >5 times as likely to have BR than women earning under $50,000 (OR=5.77, 95% CI=3.12-11.09, p<0.001). Interestingly, associations with ethnicity, social support, and information access were not significant (p>0.1, p>0.1, and p>0.5, respectively). CONCLUSION: Socioeconomic status, particularly income and education, significantly influences BR decisions. These findings suggest the need for more tailored counseling for socioeconomically disadvantaged women, as they may face greater barriers to accessing BR. The lack of significant ethnic differences indicates that socioeconomic disparities, rather than racial or ethnic factors, may play a larger role in these decisions than previously understood. Addressing these socioeconomic disparities is essential for promoting more equitable access to BR and improving outcomes for all women, regardless of their background.