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Why Some Breast Cancer Patients Forgo Implants
The study was presented at the annual meeting of the American Society of Breast Surgeons (ASBS) in Las Vegas.
About 40% of Early Breast Cancer Patients Undergo Mastectomy
Although studies have shown that women with early-stage breast cancer who undergo breast-conserving surgery and radiation live just as long as women who have a mastectomy, about 40% of women still choose mastectomy, says study leader Laura Kruper, MD, a breast cancer surgeon at City of Hope Medical Center in Duarte, Calif.
"Once they choose mastectomy, there are clear psychological benefits to reconstruction," she says.
So the researchers used California’s government-funded health care database for women treated for breast cancer in four counties from 2003 to 2007 to look into what factors influence their decisions to have implants.
Older Women, Non-Whites Less Likely to Have Breast Implants
Results showed that the number of mastectomies performed increased slightly between 2003 and 2007, and the reconstruction rate rose substantially, from 21% to 29%.
Further analysis showed:
• Women under age 40 had the highest rates of immediate reconstruction compared with any other age group. Compared with them, women 40 to 59 were 48% less likely, women 60 to 79 were 68% less likely, and women over age 80 were 93% less likely to have reconstruction.
• African-American women were less than half as likely as white women to undergo reconstruction, and Asian women had one-third the reconstruction rate of white women.
• Women with private insurance were nearly eight times more likely to have reconstruction than women with Medi-Cal insurance, California’s Medicaid program.
• Women treated at teaching hospitals were twice as likely to undergo reconstruction as women treated at other institutions.
Patient Perence 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 its patient perence. 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 studys findings.
"In my practice, closer to 90% or 95% of women opt for reconstruction," he says.
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," he says.
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 dont, Attai says.
In Corbitts 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 no cancer.
Why Some Breast Cancer Patients Forgo Implants
Monday, April 28, 2014
The study showed that older women, non-white women, women who do not have insurance, and women who are not treated at a teaching facility where a plastic surgeon is more likely to be on hand are less likely to undergo reconstruction.The study was presented at the annual meeting of the American Society of Breast Surgeons (ASBS) in Las Vegas.
About 40% of Early Breast Cancer Patients Undergo Mastectomy
Although studies have shown that women with early-stage breast cancer who undergo breast-conserving surgery and radiation live just as long as women who have a mastectomy, about 40% of women still choose mastectomy, says study leader Laura Kruper, MD, a breast cancer surgeon at City of Hope Medical Center in Duarte, Calif.
"Once they choose mastectomy, there are clear psychological benefits to reconstruction," she says.
So the researchers used California’s government-funded health care database for women treated for breast cancer in four counties from 2003 to 2007 to look into what factors influence their decisions to have implants.
Older Women, Non-Whites Less Likely to Have Breast Implants
Results showed that the number of mastectomies performed increased slightly between 2003 and 2007, and the reconstruction rate rose substantially, from 21% to 29%.
Further analysis showed:
• Women under age 40 had the highest rates of immediate reconstruction compared with any other age group. Compared with them, women 40 to 59 were 48% less likely, women 60 to 79 were 68% less likely, and women over age 80 were 93% less likely to have reconstruction.
• African-American women were less than half as likely as white women to undergo reconstruction, and Asian women had one-third the reconstruction rate of white women.
• Women with private insurance were nearly eight times more likely to have reconstruction than women with Medi-Cal insurance, California’s Medicaid program.
• Women treated at teaching hospitals were twice as likely to undergo reconstruction as women treated at other institutions.
Patient Perence 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 its patient perence. 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 studys findings.
"In my practice, closer to 90% or 95% of women opt for reconstruction," he says.
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," he says.
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 dont, Attai says.
In Corbitts 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 no cancer.
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