Why Some Breast Cancer Patients Forgo Implants
Not All Women Follow Mastectomy With Breast Reconstruction
Patient Preference Influences Breast Implants
ASBS spokeswoman Deanna J. Attai, MD, of the Center for Breast Care Inc., in
Burbank, Calif., says that in some areas, particularly rural regions, it may be
difficult to find plastic surgeons trained in reconstructive surgery.
But, she says, "sometimes it's patient preference. I am continually
surprised at the number of women, younger women, who feel it is just not
important to them. It really is an individual issue," she tells WebMD.
John Corbitt Jr., MD, a private practitioner in Palm Beach County, Fla., was
completely surprised at the study's findings.
"In my practice, closer to 90% or 95% of women opt for reconstruction," he
Nipple-Sparing Mastectomies Seem Safe
At the meeting, Corbitt presented a study of nipple-sparing
mastectomies. The procedure is just what its name implies: intricate surgery to
preserve the nipple and the areola after mastectomy.
"For years, the nipple was removed because there were worries the breast
tissue it contained had breast cells with the potential to become cancerous,"
Once considered experimental, nipple-sparing mastectomy has become common
enough that the ACSM is starting a registry to ensure women who have it fare as
well as women who don't, Attai says.
In Corbitt's small study, one of 228 procedures resulted in a recurrence of
cancer in the nipple. "So we simply went in and removed it, and the patient had
"Even if a patient does develop a cancer, it is a simple tumor that can be
removed," Corbitt tells WebMD.
"Reconstruction of the nipple is good, but it is nothing like the real
package" he says.
Women who are interested in such a procedure should know it is done at the
same time as reconstruction with a silicone implant. Only about 5% of all
centers offering mastectomy have surgeons trained in the procedure, Corbitt
As for cost, it is typically covered by insurance, he says, and about the
same price as any mastectomy with reconstruction.