Few Women Get Breast Reconstruction After Mastectomy:
THURSDAY, Dec. 8 (HealthDay News) -- Few women undergo breast
reconstruction after a mastectomy, despite the known cosmetic and
psychological advantages, a new study indicates.
"The immediate reconstruction rates are higher in women with DCIS (ductal carcinoma in situ, an early stage cancer) than with invasive cancer," said Dr. Dawn Hershman, an associate professor of medicine and epidemiology at Columbia University Medical Center, in New York City.
Fewer than one in four women with invasive cancer opts for the
immediate reconstruction of their breast, she found. More than one
in three with early stage cancer got the procedure.
Hershman and her colleagues evaluated discharge data from a
database representing 15 percent of U.S. hospitals. They found
108,992 women with invasive breast cancer who underwent a
mastectomy and 14,710 women with early stage cancer who did.
From 2000 to 2010, 23.4 percent of those women with invasive
cancers got immediate reconstruction and 36.4 percent of those with
early stage cancers did.
Those most likely to get it were women younger than age 50 who
had commercial health insurance. For those women, the rate of
reconstruction in 2010 was 67.5 percent. Along with older women,
Hershman found blacks and rural residents were less likely to get
Insurance was the biggest predictor of whether the women got
immediate reconstruction. The procedure is covered by Medicare,
Medicaid and private insurance, although there is sometimes a
That out-of-pocket charge may be a stumbling block. "The cost of
mastectomy has remained stable," Hershman said of the last decade.
"But the cost of reconstruction has increased nearly threefold over
She presented the findings Thursday at the San Antonio Breast
Cancer Symposium. The Cancer Therapy & Research Center at The
University of Texas Health Science Center at San Antonio, the
American Association for Cancer Research and Baylor College of
Medicine are joint sponsors of the meeting.
In reconstructing the breast, a surgeon rebuilds the breast's
shape, using several techniques such as implants or repositioning a
woman's own tissue.
Public policy makers should address the issue, the study authors
said, and ensure access to reconstruction for all women who desire
it. Hershman acknowledged that some women may bypass the offer for
reconstruction, for a variety of reasons, such as financial and
The findings are surprising, said Dr. Stephanie Bernik, chief of
surgical oncology at Lenox Hill Hospital, in New York City.
She acknowledged that some women decline the reconstruction.
"Some choose not to go forward," she said, with some women citing
their desire to avoid more surgery. However, she thinks some women
may not be aware of the option or they may not be aware of
insurance coverage for it. Some who must pay a co-pay may decline
for financial reasons, she said.
Previous research by others has found that women without
insurance are often not told about the option. "Women have to be
made aware that reconstruction is an option," Bernik said. If there
is an issue with finances, she said, women should consider asking
their doctor about arranging a payment plan.
Immediate reconstruction is now the standard of care, she said.
However, in some cases, a reconstructive surgery may be best
delayed after certain cancer treatments.
Because this study was presented at a medical meeting, the data
and conclusions should be viewed as preliminary until published in
a peer-reviewed journal.
Visit the American Society of Plastic Surgeons to learn more
Copyright © 2011
. All rights reserved.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.