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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 says.

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," he says.

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 no cancer.

"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 says.

As for cost, it is typically covered by insurance, he says, and about the same price as any mastectomy with reconstruction.

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