(HealthDay News) — The use of breast reconstruction in breast cancer patients undergoing mastectomy has been increasing in the United States, according to research published online Feb. 18 in the Journal of Clinical Oncology.

Reshma Jagsi, MD, DPhil, of the University of Michigan in Ann Arbor, and colleagues analyzed data from 1998 to 2007 for 20,560 women (median age, 51 years) with employment-based health insurance, who underwent mastectomy for breast cancer. The researchers sought to examine trends and variation in the use of breast reconstruction.

The researchers found that use of breast reconstruction in women undergoing mastectomy for breast cancer increased significantly, from 46% in 1998 to 63% in 2007. The use of implants increased while use of autologous techniques decreased over time.

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Significantly more women received bilateral mastectomies in 2007 (18%) than in 1998 (3%). Patients receiving bilateral mastectomies were significantly more likely to undergo reconstruction (odds ratio [OR], 2.3), and patients receiving radiation therapy were less likely to undergo reconstruction (OR, 0.44).

Reconstruction rates also varied widely according to geographic region and were associated with density of plastic surgeons in each state and income at the county level.

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“In this large, observational analysis of breast reconstruction utilization in the United States in a commercially insured sample, we observed a strong trend toward increased use of reconstruction over time, with substantial growth in the use of implant-based techniques and decreasing use of autologous reconstruction,” the researchers wrote.

However, in an accompanying editorial, Lindi H. VanderWalde, MD, of the Baptist Cancer Center, and Stephen B. Edge, MD, of the Baptist Cancer Center and the Vanderbilt University School of Medicine, noted that health care disparities in breast reconstruction persist.

“Solutions to improving access to breast reconstruction must be found, while at the same time assuring that we fully communicate the realities of the value of surgical choices, minimize what may otherwise be considered overtreatment, and listen to our patients’ preferences,” they wrote. 

Two authors disclosed financial ties to biomedical companies.


  1. Jagsi R, Jiang J, Momoh AO, et al. Trends and Variation in Use of Breast Reconstruction in Patients With Breast Cancer Undergoing Mastectomy in the United States. J Clin Oncol. 2014;doi:10.1200/JCO.2013.52.2284.
  2. VanderWalde LH, Edge SB. Decision Shared or Otherwise: The Ongoing Evolution of Local Therapy for Breast Cancer. J Clin Oncol. 2014;doi:10.1200/JCO.2013.54.3082.