Supplemental Table 1.Codes used for data procurement

Variable / Description
CPT codes
19366 / Breast reconstruction with other technique
14000 / Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less
14001 / Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30 sq cm
14301 / Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm
14302 / Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof
13100 / Repair, complex, trunk 1.1 cm to 2.5 cm
13101 / Repair, complex, trunk 2.6 cm to 7.5 cm
13102 / Repair, complex, trunk each additional 5 cm or less
ICD-9 codes
Hematoma
998.1 / Complications of hematoma
998.11 / Hemorrhage complicating a procedure
998.12 / Hematoma complicating a procedure
Seroma
998.13 / Seroma complicating a procedure
Wound
998.3 / Disruption of operative wound
998.31 / Disruption of internal operation wound
998.32 / Disruption of external operation wound
998.83 / Non-healing surgical wound
Infection
998.5 / Postoperative infections
998.51 / Infected post-operative seroma
998.51 / Infected postoperative seroma
998.59 / Other postoperative infection
998.59 / Other postoperative infection (abscess)
996.6 / Infection and inflammatory reaction due to internal prosthetic device implant and graft
996.69 / Infection and inflammatory reaction due to other internal prosthetic device, implant, and graft
Implant complication
996.5 / Mechanical complication of other specified prosethetic device implant and graft
996.52 / Mechanical complication due to graft of other tissue, not elsewhere classified
996.54 / Mechanical complication due to breast prosthesis
996.55 / Mechanical complication due to artifical skin graft and decellularizedallodermis
996.59 / Mechanical complication due to other implant and internal device, not elsewhere classified
996.7 / Other complications due to internal prosthetic device, implant, and graft
996.74 / Other complications due to other vascular device, implant, and graft
996.79 / Other complications due to other internal prosthetic device, implant, and graft

cm, centimeters; CPT, current procedural terminology; ICD-9, international classification of diseases, ninth edition; sq, square

Supplemental Table 2. Analysis of TM compared with TM+R

Variable / TM (n=3263) / TM+R (n=2608) / TM cf. TM+R
N / % / N / % / P-value
Age
Median, years (range) / 56 (19-98) / 50 (20-81) / <0.0001
Under 40 / 316 / 10.3 / 414 / 17.0
40 to 49 / 655 / 21.3 / 785 / 32.2
50 to 59 / 869 / 28.2 / 765 / 31.4
60 to 69 / 745 / 24.2 / 414 / 17.0
70 to 79 / 379 / 12.3 / 56 / 2.3
80 to 84 / 79 / 2.6 / 3 / 0.1
85 and older / 37 / 1.2 / 0 / 0.0
Race
White / 1978 / 64.2 / 1670 / 68.5 / <0.0001
Asian / 186 / 6.0 / 126 / 5.2
Black / 417 / 13.5 / 231 / 9.5
Hispanic / 427 / 13.9 / 357 / 14.7
Other / 13 / 0.4 / 11 / 0.5
Unknown / 59 / 1.9 / 42 / 1.7
Obesity
Yes / 2005 / 66.5 / 1552 / 64.6 / 0.0852
No / 38 / 1.3 / 18 / 0.8
Not available / 972 / 32.2 / 833 / 34.7
Clinical T stage
Tis / 395 / 12.1 / 659 / 25.3 / <0.0001
T1 / 667 / 20.4 / 836 / 32.1
T2 / 1084 / 33.2 / 827 / 31.7
T3 / 440 / 13.5 / 134 / 5.1
T4 / 501 / 15.4 / 28 / 1.1
Not available / 167 / 5.1 / 118 / 4.5
Clinical N stage
N0 / 1710 / 52.4 / 2103 / 80.6 / <0.0001
N1 / 848 / 26.0 / 316 / 12.1
N2 / 159 / 4.9 / 41 / 1.6
N3 / 405 / 12.4 / 51 / 2.0
Clinical M stage
M0 / 2969 / 91.0 / 2493 / 95.6 / <0.0001
M1 / 153 / 4.7 / 14 / 0.5
Clinical stage
Stage 0 / 392 / 12.0 / 660 / 25.3 / <0.0001
Stage 1 / 527 / 16.2 / 741 / 28.4
Stage 2 / 1145 / 35.1 / 930 / 35.7
Stage 3 / 886 / 27.2 / 144 / 5.5
Stage 4 / 154 / 4.7 / 14 / 0.5
Not available / 159 / 4.9 / 119 / 4
Tumor location
Upper inner / 514 / 15.8 / 446 / 17.1 / 0.17
Upper outer / 1390 / 42.6 / 1015 / 38.9 / 0.0044
Lower inner / 281 / 8.6 / 167 / 6.4 / 0.0015
Lower outer / 329 / 10.1 / 228 / 8.7 / 0.0816
Central / 810 / 24.8 / 656 / 25.2 / 0.77
Multicentric / 272 / 8.3 / 122 / 4.7 / <0.0001
Preoperative treatment
None / 1449 / 44.8 / 1817 / 71.3 / <0.0001
Chemotherapy / 1656 / 50.8 / 656 / 25.2 / <0.0001
Hormonal / 148 / 4.5 / 58 / 2.2 / <0.0001
Other / 55 / 1.7 / 36 / 1.4 / 0.0024
Tumor grade
Low / 259 / 7.9 / 276 / 10.6 / <0.0001
Intermediate / 1193 / 36.6 / 1173 / 45.0
High / 1600 / 49.0 / 1093 / 41.9
Not available / 211 / 6.5 / 66 / 2.5
Multifocal
Yes / 888 / 27.2 / 751 / 28.8 / 0.0248
No / 1636 / 50.1 / 1586 / 60.8
Not available / 739 / 22.7 / 271 / 10.4
Lymphovascular invasion
Yes / 983 / 30.1 / 447 / 17.1 / <0.0001
No / 1960 / 60.1 / 1986 / 76.2
Not available / 320 / 9.8 / 175 / 6.7
Margin status
Positive / 12 / 0.4 / 7 / 0.3 / 0.38
Close (<2mm) / 88 / 2.7 / 54 / 2.1
Negative / 3140 / 96.2 / 2529 / 97.0
Not available / 23 / 0.7 / 18 / 0.7
ER
Positive / 2418 / 74.1 / 2078 / 79.7 / <0.0001
Negative / 757 / 23.2 / 455 / 17.5
Not recorded / 88 / 2.7 / 75 / 2.9
PR
Positive / 1890 / 57.9 / 1689 / 64.8 / <0.0001
Negative / 1273 / 39.0 / 832 / 31.9
Not recorded / 100 / 3.0 / 87 / 3.3
HER2
Positive / 599 / 18.4 / 327 / 12.5 / <0.0001
Negative / 2289 / 70.2 / 1727 / 66.2
Not recorded / 375 / 41.7 / 554 / 21.3
Triple negative
Yes / 456 / 14.0 / 246 / 9.4 / <0.0001
No / 2196 / 67.3 / 1677 / 64.3
Not recorded / 611 / 18.7 / 685 / 26.3
Adjuvant chemotherapy
Yes / 1044 / 32.0 / 831 / 31.9 / <0.0001
No / 1950 / 59.8 / 1640 / 62.9
Not recorded / 269 / 8.2 / 137 / 5.3
Adjuvant hormonaltherapy
Yes / 1728 / 53.0 / 1417 / 54.3 / 0.57
No / 1089 / 33.4 / 849 / 32.6
Not recorded / 446 / 13.7 / 342 / 13.1
Adjuvant radiationtherapy
Yes / 1600 / 49.0 / 559 / 21.4 / <0.0001
No / 1314 / 40.3 / 1786 / 68.5
Not recorded / 349 / 10.7 / 263 / 10.1

cf, compare with; ER, estrogen receptor; HER2, human epidermal growth factor receptor 2; PR, progesterone receptor; SD, standard deviation; TM, total mastectomy; TM+R, total mastectomy with reconstruction