Rising Rates of Rebuilding Breasts After Mastectomy

Breast reconstruction after mastectomy for breast cancer more common in recent years

(RxWiki News) For some women with breast cancer, a procedure to remove a breast might be a part of treatment. New research explored how many of these women undergo reconstructive surgeries after these procedures.

This new study followed women who had a mastectomy — the partial or full removal of a breast — and looked for instances of surgery to rebuild the area.

The study found that from 1998 to 2007, rates of breast reconstruction after a mastectomy increased significantly.

"Talk to your doctor about healing after mastectomy."

According to the authors of this study, led by Reshma Jagsi, MD, DPhil, of the Department of Radiation Oncology at the University of Michigan in Ann Arbor, breast reconstruction surgery has been tied to mental and social benefits for patients who have undergone mastectomy. However, Dr. Jagsi and team explained there have been concerns about equal access to breast reconstruction across the US.

To explore the rates of these procedures, the researchers utilized the MarketScan Commercial Claims and Encounters database, which gathers information from people across the US with health insurance through their employers.

In total, 20,560 women who had a mastectomy during 1998 to 2007 were identified. The women had an average age of 51 years old. The researchers then looked for instances of breast reconstruction within two years of the patients' mastectomy.

Overall, 56 percent of the women who underwent mastectomy later had breast reconstruction. The researchers found that the rate of breast reconstruction increased significantly during the time of the study.

In 1998, 46 percent of the 477 women who underwent mastectomy had breast reconstruction — a number that increased to 63 percent of the 4,750 women who had a mastectomy in 2007. The researchers noted that the MarketScan database also grew over the time period.

Rates of bilateral mastectomy, which involves the removal of both breasts, also increased during this time — from 3 percent of cases in 1998 to 18 percent in 2007. These patients were 76 percent more likely to have breast reconstruction.

The rates varied a great deal across the US. The researchers noted that higher breast reconstruction rates seemed to be associated with areas with more plastic surgeons and higher income levels.

"Reconstruction rates ranged from a low of 18 percent (two of 11 patients) in North Dakota to a high of 80 percent (12 of 15 patients) in Washington, DC," Dr. Jagsi and team noted.

In a news release from the University of Michigan Health System, another study author, Benjamin Smith, MD, of the The University of Texas MD Anderson Cancer, explained these findings show progress, but highlight areas that may need improvement.

"Overall, our finding of substantial increases in breast reconstruction over time is good news for women with breast cancer and reflects positively on cancer care in the United States," said Dr. Smith. "However, we need to keep working to ensure that all women have access to quality breast cancer care.”

It is important to note that this study only looked at women with health insurance through employers. Further research is needed.

This study was published online February 18 in the Journal of Clinical Oncology.

Review Date: 
February 18, 2014