More Breast Cancer Patients Choosing Reconstructive Surgery, Study Finds
But rates vary widely from state to state, and doctors worry that not all women have equal access to procedures
By Mary Brophy Marcus
TUESDAY, Feb. 18, 2014 (HealthDay News) -- More breast cancer patients are choosing reconstructive breast surgery, although where women live might influence whether they opt for it, new research shows.
"These data suggest that while a hearteningly increasing proportion of women are receiving breast reconstruction, it's not uniformly the case all across the country," said study author Dr. Reshma Jagsi, associate chairwoman of the department of radiation oncology at the University of Michigan.
According to the study, which was published online Feb. 18 in the Journal of Clinical Oncology, there was an almost 20 percent jump in reconstructive breast surgeries between 1998 and 2007 among women who'd had a breast removed due to breast cancer (a procedure called mastectomy).
Meanwhile, the number of double mastectomies, which high-risk women sometimes choose as a preventive measure against breast cancer, increased from 3 percent to 18 percent in the same period. Three-quarters of women who got double mastectomies also got breast reconstruction, the study found.
One expert had some theories on the trends.
"I think the rising number of women choosing to have [preventive] double mastectomy has gone up in part because advances in reconstructive techniques allow them to feel more confident that they will look good after mastectomy," said Dr. Oren Lerman, director of breast reconstruction at the Institute for Comprehensive Breast Care at Lenox Hill Hospital in New York City.
"The increase in percentage of women having reconstruction [after breast cancer] is probably more related to better access to information and plastic surgeons," Lerman said. "But there's still a ways to go."
Jagsi said she and her colleagues first wanted to investigate the issue because there was little information available on it since the Women's Health and Cancer Rights Act of 1998 was passed. The law says health insurers who offer mastectomy coverage must also provide for all stages of breast reconstruction.
Jagsi and her team looked at data from more than 20,000 women who underwent a mastectomy during a 10-year period. The average age of the patients was 51. Jagsi said they found that reconstructive breast surgery increased from 46 percent in 1998 to 63 percent in 2007.
More women might be opting to have reconstructive surgery now because of the law, Jagsi said, but also because there might be more access to information about their options.
There was "tremendous" variation in rates of reconstructive surgery across the United States, Jagsi said, and that variability reflects the density of plastic surgeons who perform reconstructive breast procedures in those parts of the country. For example, only 18 percent of breast cancer patients opted for reconstructive surgery in North Dakota, compared to 80 percent of women in Washington, D.C.