Race, Age, Geography, Significantly Decrease Odds of Breast Reconstruction After Mastectomy, Says ASPS

2/27/2003

From: Theresa Hill or LaSandra Cooper, 847-228-9900 media@plasticsurgery.org; both of American Society of Plastic Surgeons

ARLINGTON HEIGHTS, Ill., Feb. 27 -- The likelihood that African American, Hispanic, and Asian women have breast reconstruction after mastectomy is significantly lower than Caucasian women, even though reconstruction plays an important role in a patient's emotional healing after a mastectomy. According to a study published in the February issue of Plastic and Reconstructive Surgery(r), the official medical journal of the American Society of Plastic Surgeons (ASPS), whether a woman chooses to have breast reconstruction is significantly influenced by the patient's race, age, geographic location and stage of disease.

The study examined 10,406 patients who had mastectomies due to breast cancer. Of these patients, 1,607 had breast reconstruction within four months after mastectomy. Despite the safety of immediate and early delayed breast reconstruction, there is an overall low rate of breast reconstruction across all demographics, the authors note. According to the ASPS, 81,729 women had breast reconstruction in 2001.

-- Race Influences Breast Reconstruction -- According to the study, African American, Hispanic and Asian women were significantly less likely to have breast reconstruction than Caucasian women.

"African Americans generally receive less medical care, receive less aggressive treatment interventions and are diagnosed at later stages of disease," said Dr. Wilkins. "However, Asian women, who often receive the same level of medical care as Caucasians, were also less likely to have breast reconstruction. While we do not know the specific reason for this gap, we believe the cultural value of women's breasts may differ across ethnicity."

-- Age Influences Breast Reconstruction -- According to the study, women 35 to 44 years old were more likely to have breast reconstruction as compared to women aged 45 to 54. Women aged 55 and older were less likely to have the procedure.

"The effect of age on breast reconstruction is striking," said Dr. Wilkins. "We can only presume that older women may have different priorities and different perceptions of mortality, which may influence their decision to have

-- Geographic Location Influences Breast Reconstruction -- Out of the 11 geographic locations studied, Atlanta reported the highest rate of breast reconstruction patients with 34 percent. Hawaii had the lowest rate with eight-percent.

-- Overall, Breast Reconstruction Is Underutilized -- "Further research is needed to evaluate the impact of provider bias, patient preference and barriers to care on the utilization of breast reconstruction in the United States," said Dr. Wilkins. "Only by understanding these demographic influencers can we help remove the obstacles that keep women from getting the comprehensive care they need during the entire cycle of breast cancer."

ASPS, founded in 1931, is the largest plastic surgery organization in the world and the foremost authority on cosmetic and reconstructive plastic surgery. ASPS represents physicians certified by The American Board of Plastic Surgery (ABPS) or The Royal College of Physicians and Surgeons of Canada. For referrals to ABPS-certified plastic surgeons in your area and to learn more about cosmetic and reconstructive plastic surgery, call the ASPS at 1-(888) 4-PLASTIC (1-888-475-2784) or visit http://www.plasticsurgery.org.