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
Jagsi said it's heartening that more women are having reconstructive breast surgery after a mastectomy, but she said she's concerned about health disparities.
"One of the take-home messages from this study is that some women simply don't have the access to plastic and reconstructive surgeons who can offer them breast reconstruction," she said. "We want to make sure there is appropriate access to this treatment for women who choose to pursue it."
Lerman said the study delivers comforting news.
"A study like this highlights one major thing -- that options for women undergoing mastectomy are numerous," she said. "Some of these reconstructive methods are really advanced to the point that it will make a woman look and feel normal, not just when she's wearing clothing but even when she's not. That really reassures women who are facing mastectomy."
But there are two side of the coin, and Lerman said he's concerned about the gaps in coverage as well. "A large percentage of women are not having reconstruction, and it is probably because they simply don't have access or are not being referred to reconstructive surgeons," he said.
Reimbursements may have changed, too, limiting women's options in some states, said Dr. Subhakar Mutyala, associate director of the department of radiation oncology at Baylor Scott & White Cancer Institute in Temple, Texas.
"The law states that reimbursement has to occur, but what that numerical value of the reimbursement is may have decreased over the past few years," Mutyala said.
Jagsi said the study showed several other notable trends, including a shift toward more women choosing to have implant-based surgery instead of autologous surgery, which involves using a woman's own tissue from other areas of her body. The research also showed that patients who received radiation therapy were less likely to undergo plastic surgery than those who had a mastectomy alone.
Mutyala said he found it interesting that the number of artificial implant procedures has gone up. "I think some of that may be the reduction in fear of silicon implants," he said. "Fifteen or 20 years ago, they had complications and side effects and there was a lot of fear-mongering about them, but slowly that perception has gone away."
Celebrities such as Angelina Jolie, who share their preventive mastectomy or post-cancer stories, are shining a brighter light on women's plastic surgery options after breast cancer too, Jagsi said. The researchers did not study that phenomenon, however.
"This is not about vanity," Jagsi stressed. "It's about physical, mental and social well being -- all of those dimensions. It can be critically important to our patients."