Why Some Breast Cancer Patients Forgo Implants
Not All Women Follow Mastectomy With Breast Reconstruction
WebMD News Archive
Economics, Hospital May Influence Choice to Have Breast Implants
Kruper says many non-teaching hospitals may not have plastic surgeons on
staff to perform reconstructive surgery, particularly if women want it months
So-called "delayed reconstruction" was offered only at a limited number of
hospitals in the four-county area, and its availability rose only slightly over
the course of the five-year study, she says.
Economics may be another important factor, Kruper says. "The shortage of
plastic surgeons willing to accept Medi-Cal’s lower reconstruction
reimbursement rates likely limits the ability of these patients to undergo
reconstruction when desired," she says.
One of the major drawbacks of the study is that women were not asked whether
they voluntarily forwent breast implants or whether it wasn't offered.
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