05.13.07
What does your doctor know about breast reconstruction?
If you have or have had or are related to someone who has… actually… everybody should know this. A recent 2007 study in the journal Cancer concludes “A large proportion of surgeons do not refer breast cancer patients to plastic surgery at the time of surgical decision-making. Surgeons who have a high referral propensity are more likely to be women, to have a high clinical breast volume, and to work in cancer centers… Women need more opportunities to discuss reconstructive options to make informed surgical treatment decisions about their breast cancer. ”
In short the study found a large proportion of general surgeons who treat breast cancer with mastectomies or lumpectomies never refer their patients to a plastic surgeon for reconstruction. A survey of 365 surgeons with 1,844 patients in 2002 revealed only 24 percent of surgeons referred more than three-quarters of their patients for plastic surgery, and 44 percent referred fewer than one-quarter. Fewer than 20 percent of breast cancer patients undergo breast reconstruction, according to background information in the article, which appeared online March 26 in the journal Cancer.
Surgeons who had a large volume of cases and those who worked in specialized cancer centers were more likely than others to refer patients for plastic surgery. And, while 62 percent of women referred more than three-quarters of their patients, only 28 percent of men did.
The article went on to reveal why many surgeons did not refer their patients for breast reconstruction.
- 64 percent said their patients were not interested
- 39 percent believed that their patients thought it would take too long
- almost half said the women were concerned about the cost
Here are some things to know:
1. There are a multitude of reconstructive optios which include using implants, using your own tissue or a combination of the two. A detailed discussion about the surgery options should be conducted with a specialist.
2. There is a great deal of flexibility in the timing of breast reconstruction to find a plan that best suits the patient. Breast reconstruction can be immediate for select patients (this depends of the type of breast cancer and how advanced it may be as well as types of therapy you may or may not require after the cancer has been surgically removed.) Generally, breast reconstruction can take place at any point after the cancer resection and treatment has taken place. This means six months to 40 years later.
3. Some reconstruction is less intensive than others.
4. Breast reconstruction – no matter when the cancer was removed – is a federally mandated covered insurance benefit. Your health insurance should provide you with a pathway to have breast reconstruction as well as cover things like creating a new nipple, creating symmetry between the breasts (which many times requires a breast lift on the normal breast).
5. Ideally much of this discussion should occur before the cancer surgery. This is not always possible, but ensures the maximal number of options.
The key is a good rapport with your doctor. If you have questions – they should be able to help you with answers. The study also revealed that patient’s were more likely to get a referral to a plastic surgeon if the referring doctor was a woman, if the doctor worked in a cancer center or if they had a high volume of breast cancer patients.
Something to remember.
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