Undergoing reconstructive surgery may seem like a forgone conclusion for survivors of breast cancer, but that doesn't appear to be the case. A new study has found that most breast cancer survivors who undergo a mastectomy decide against surgical reconstruction of their breasts.
The reasons for such a decision vary, according to the breast reconstruction study published Wednesday in JAMA Surgery. More than 48 percent of those who decide against reconstruction say they don't want to undergo additional surgery, almost 34 percent say reconstruction isn't important and 36 percent cite a fear of breast implants.
In fact, only about 42 percent of women choose reconstructive surgery after their mastectomy.
Not only is Laura Kruper, M.D., director of the Rita Cooper and J. William Finkel Women’s Health Center, unsurprised by the number of women who forgo reconstruction, she finds the number of patients who do choose surgery encouraging.
“Past studies have documented that average reconstruction rates after mastectomy range from 25 to 35 percent,” Kruper told HealthDay. "The reality is that there will always be some women who do not wish to have breast reconstruction after mastectomy.”
Nonetheless, Kruper said, the numbers indicate that more patient education is needed. Many women in the study said they worried that reconstruction could interfere with detection of a recurrence of breast cancer, a fear that breast cancer experts say is unfounded. Another 18 percent of women said they didn't know reconstruction was an option.
The study, led by researchers at Memorial Sloan Kettering Cancer Center in New York, was conducted by reviewing government data. It included 485 women who had been diagnosed with breast cancer between 2005 and 2007.
Older women, African-American women and women with less education were less likely to choose reconstruction. Women who had additional major health problems and those who underwent chemotherapy were also less likely to choose reconstructive surgery.
Lack of insurance was cited by about 12 percent of women, despite a 1998 federal law that requires most group insurance plans that cover mastectomies to also cover reconstructive surgery. However, reimbursement rates are often low, so not all surgeons accept the rates.
For the most part, the study is good news: Whether women chose breast reconstruction or not, nearly 87 percent reported being satisfied four years after their diagnosis.