Advice lacking on reconstruction after mastectomy
NEW YORK (Reuters Health) - "Surprisingly" few women having mastectomy for breast cancer are referred by their general surgeon to a plastic surgeon to discuss reconstruction options, results of a survey suggest.
"There are a lot of psychological benefits of breast reconstruction for women who want it, yet it is significantly underused," Dr. Amy Alderman, an assistant professor of plastic surgery at the University of Michigan, Ann Arbor, noted in a telephone interview with Reuters Health.
It's estimated that only 16 percent of mastectomy patients undergo breast reconstruction. The current survey suggests that doctors need to do a better job of informing breast cancer patients about breast reconstruction, Alderman said.
Among 365 general surgeons from Detroit and Los Angeles who responded to a survey regarding breast reconstruction, 44 percent said they referred less than a quarter of eligible women to plastic surgeons for reconstruction.
Only 24 percent said they referred three-quarters or more of their mastectomy patients for breast reconstruction, Alderman and colleagues report in the journal Cancer.
"I was surprised by how few surgeons referred mastectomy patients to plastic surgeons for reconstruction," Alderman said, given that the US government passed a law nearly a decade ago that mandates insurance coverage for breast reconstruction.
Female surgeons, surgeons who performed more than 50 mastectomies annually, and surgeons whose offices were located in cancer centers were most likely to refer mastectomy patients to plastic surgeons for breast reconstruction.
"Low-referral" surgeons cited inadequate knowledge by women, high cost of reconstruction, and unavailability of plastic surgeons as reasons for not referring mastectomy patients for reconstructive surgery. Many surgeons also felt breast reconstruction was of little concern to women compared to other aspects of their breast cancer care.
"Women should be given information on breast reconstruction and it looks like they are not," Alderman concluded. "If a woman is interested in breast reconstruction, she should bring it up with her general surgeon," she advised.
SOURCE: Cancer, May 1, 2007.
What breastcancer.org says about this article…
Advice lacking on reconstruction after mastectomy
Reconstruction after breast cancer surgery (mastectomy or lumpectomy) is an important option to consider. The reasons for breast reconstruction vary with lifestyle, occupation, and personality. About 75% of women who have mastectomies go on to have surgical reconstruction of one or both breasts.
The study reviewed here suggests that many women aren't referred to a plastic surgeon after breast cancer surgery.
If you've had a breast removed or are about to have one removed, it's important to talk to your doctor about breast reconstruction. If you had a lump removed that left you feeling out of balance, you also might want to talk to your doctor about reconstruction. You may decide not to have reconstruction, but it's a good idea to consider all your options. If your surgeon doesn’t bring up reconstruction, ask for more information and a referral.
There are several things to consider when evaulating your options for breast reconstruction:
- Timing. The stage of the breast cancer affects when reconstruction should be done. For example, if the cancer is early stage, small, and hasn't spread to the lymph nodes, reconstruction may be able to be done at the same time as surgery.
- Type of reconstruction. There are choices in breast reconstruction. Saline or silicon gel implants are one option. Tissue transplanted from your own back, belly, or buttocks can also be used to fashion a new breast.
For more information, visit the breastcancer.org Reconstruction Section.