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Fewer Black Women Get Breast Reconstruction

Doctors Less Likely to Offer, Fewer Black Women Accept Post-Mastectomy Reconstruction
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WebMD Health News

Aug. 23, 2004 -- Black women get breast reconstruction surgery less often after breast cancer mastectomy than women of other ethnic groups, according to a new study.

The study, which appears in the online edition of the journal CANCER, included 1,004 women who had a mastectomy for breast cancer at a U.S. cancer center from 2001-2002.

Participants included 718 non-Hispanic whites, 99 blacks, 112 Hispanics, 45 Asians, and 30 Middle Eastern women.

Some were international patients who came to the U.S. for treatment; most of the Middle Eastern participants lived overseas.

Women who undergo mastectomy can choose to get breast reconstruction surgery right away or have the surgery later. Immediate breast reconstruction has been tied to improved psychological well-being and better cosmetic results, according to the researchers.

In the study, 376 women opted for immediate breast reconstruction. That included 20% of blacks compared with 40% of whites, 42% of Hispanics and Asians, and 10% of Middle Eastern women.

Since some patients choose to wait a while between their mastectomy and reconstruction, the researchers also counted the number of women who delayed reconstruction surgery.

Black women were near the bottom of that list, too.

Of the study's participants, 37% of Middle Eastern women, 5% of whites, 2% of blacks, 3% of Hispanics, and no Asians got delayed breast reconstruction.

Researchers wanted to see if there were any differences among the ethnic groups in the number of women who were told by their doctors about breast reconstruction and how many women opted to get the surgery.

They found that doctors were less likely to offer referrals for reconstruction or the surgery itself to black women.

But black women also played a role. They were less likely to accept referral offers and less likely to choose to get the surgery if it was offered.

Cultural differences regarding body image, self-esteem, and acceptance of medical authority may have contributed to the differences among the ethnic groups, the researchers say.

"Patient social networks, perception of self in relation to the health care system, and factors as diverse as the level of Internet use may affect patient decision-making," write the researchers in the online edition of the journal CANCER.

The study was led by Henry Keurer, MD, PhD, of the M.D. Anderson Cancer Center in Houston.

SOURCES: Kuerer, H. CANCER (online edition), August 23, 2004. News release, CANCER.

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