FINDING HOPE AFTER MASTECTOMY

Women without Insurance Less Likely to Get Breast Reconstruction after Mastectomy

At the 2011 San Antonio Breast Cancer Symposium in December of 2011, some interesting information regarding women’s responses to breast cancer were presented with some surprising results. Despite the fact that women benefit in a number of ways from having breast reconstructive procedures performed following the removal of the breast (mastectomy) due to breast cancer, only a small minority of breast cancer survivors go through with the procedures.

Currently, only about a third of the women having mastectomies today are taking the extra step to have breast reconstruction performed, according to Dawn Hershman, M.D. of Columbia University Medical Center in New York. Given the well-known psychological benefits conferred by breast reconstructive surgery, one would think the number of women having the procedure performed following mastectomy would be much higher. Women who have undergone mastectomies and have subsequent breast reconstructive surgery have an improved quality of life, according to research. Women feel better about their body and self-esteem is considerably higher when women opt not to delay having breast reconstruction performed, but rather go ahead with it right away.

The study presented at the San Antonio symposium included 106,988 participants who were identified by insurance codes. These women were then analyzed based on the frequency with which they sought out reconstructive surgery, the type of insurance they carried, and a number of other important variables such as race and age. In the study, only 22.6 percent of the women undergoing mastectomy sought out immediate breast reconstruction. One of the biggest factors the seemed to play a role in the decision to have a mastectomy had to do with health insurance, according to the other variables that were analyzed in the study. Women who went ahead and underwent immediate breast reconstructive surgery were much more likely to have health insurance than women who did not.

Women with commercial insurance have been the ones to most frequently seek out breast reconstruction immediately following a mastectomy, particularly women in under-50 age group. Among women who underwent a mastectomy at less than 50 years of age, 67.5 percent went ahead with breast reconstructive surgery. In other words, women who had commercial insurance were three times more likely to go ahead and have the plastic surgery procedure than women who didn’t have health insurance in place to cover the procedure.

Overall, there has been an increase in the number of women who have breast reconstructive surgery immediately following a mastectomy but the numbers are still really low. Among women who are younger than 50 years old, only 41.8 percent get the surgery done right away. The numbers are even lower for women over age 50. Less than 20 percent of women in this age bracket do the procedure right away. Researchers have asserted that public policy needs to be in place to provide immediate reconstructive options to post-mastectomy patients. Women who have gone through the ordeal of having breast cancer and a full mastectomy should have access to breast reconstructive surgery regardless of whether they have insurance or not.

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