Many Women Not Getting Breast Reconstruction After Mastectomy

Less than one-quarter of women who have a mastectomy undergo immediate breast reconstruction. These results were presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium.

For some women with breast cancer, treatment will include a single or double mastectomy (removal of one or both breasts). In order to restore the appearance of a breast, women may choose to undergo breast reconstruction after their mastectomy. Research suggests that immediate breast reconstruction can improve psychological well-being.

Breast reconstruction surgery has become increasingly refined and can be successfully accomplished in almost all women treated with mastectomy. The goal of breast reconstruction surgery is to create a breast that matches the opposite breast. This can be accomplished by using a breast implant alone, by actually reconstructing the breast with the patient’s own tissue, or by utilizing a combination of these two techniques.

To explore the frequency and predictors of immediate breast reconstruction, researchers collected information about more than 106,000 breast cancer patients who had undergone mastectomy between 2000 and 2010.

  • Overall, 23% of women underwent immediate breast reconstruction.
  • Rates of immediate reconstruction increased over time, from 15% in 2000 to 33% in 2010.
  • Compared with women without health insurance, women with commercial health insurance were three times more likely to undergo breast reconstruction.
  • Women were less likely to undergo immediate reconstruction if they were older, black, treated at a rural or non-teaching hospital, or had multiple other health problems.

These results suggest that although rates of post-mastectomy breast reconstruction have increased over time, they remain low. Of the factors evaluated, insurance status was one of the strongest predictors of who received breast reconstruction. The researchers encourage public policy that ensures access to reconstructive surgery for all women.

Reference: Hershman DL, Neugut A, Richards CA et al. Influence of hospital factors, physician factors and type of health insurance of receipt of immediate postmastectomy reconstruction in young women with breast cancer. Presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. December 6-10, 2011. Abstract S6-3.

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