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A 10-year retrospective review was performed using tumor registry data at Lehigh Valley Hospital, a tertiary care facility in Allentown, Pennsylvania. The tumor registry is a hospital database that tracks all individuals who have cancer, including breast cancer. All female patients who underwent mastectomy for breast cancer between 1988 and 1997 were included. The general surgeons at our institution performed all mastectomies. As a result, a single cohort of patients was followed-up longitudinally from tumor registry entrance through the end of the study period, regardless of mortality or loss to follow-up. Patients are entered into the tumor registry at time of diagnosis and contacted for follow-up on an annual basis. Male patients and patients who underwent prophylactic mastectomies were excluded from this study. Patient groups consisted of those who had mastectomy without reconstruction, mastectomy with …