Post-Mastectomy Reconstruction Factors Found

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Factors linked to not undergoing reconstruction include black race and lower educational level.
Factors linked to not undergoing reconstruction include black race and lower educational level.

More than 40 percent of women undergo breast reconstruction following mastectomy and most patients are satisfied with the reconstruction decision-making process, according to a study published online in JAMA Surgery.

Monica Morrow, M.D., from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues examined correlates of breast reconstruction after mastectomy using Surveillance, Epidemiology, and End Results registries.

A sample of women, aged 20 to 79 years, diagnosed with ductal carcinoma in situ or stages I to III invasive breast cancer were included. To ensure adequate representation of racial/ethnic minorities, black and Latina women were overrepresented. Data were analyzed for 485 women who remained disease free at follow-up.

RELATED: Preventive Mastectomy Has Minimal Survival Benefit

The researchers found that 24.8 and 16.8 percent of participants underwent immediate and delayed reconstruction, respectively (overall, 41.6 percent). Black race, lower educational level, increased age, major comorbidity, and chemotherapy were factors associated with not undergoing reconstruction.

Dissatisfaction with the reconstruction decision-making process was reported by 13.3 percent of women, with higher dissatisfaction among nonwhite patients. The most common reasons for not having reconstruction included wanting to avoid additional surgery and the belief that it was not important (48.5 and 33.8 percent, respectively); 36.3 percent expressed fear of implants.

"Specific approaches are needed to address lingering patient-level and system factors with a negative effect on reconstruction among minority women," the authors write.

  1. Morrow, Monica, MD, et al. "Access to Breast Reconstruction After Mastectomy and Patient Perspectives on Reconstruction Decision Making." JAMA Surgery. doi:10.1001/jamasurg.2014.548. August 20, 2014.

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