Few referrals for breast reconstruction

Interesting report from the New York Times Science Section today:

A large proportion of breast surgeons never refer their patients to a plastic surgeon for reconstruction, a new study reports.

Researchers surveyed 365 surgeons with 1,844 patients in Detroit and Los Angeles in 2002. Only 24 percent of surgeons referred more than three-quarters of their patients for plastic surgery and 44 percent referred fewer than one-quarter.<o></o>

Over all, fewer than 20 percent of patients undergo breast reconstruction, according to background information in the article, which appeared online March 26 in the journal Cancer.<o></o>

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.<o></o>

When the surgeons were asked why they did not refer women for breast reconstruction, 64 percent said their patients were not interested, 39 percent believed that their patients thought it would take too long, and almost half said the women were concerned about the cost, even though federal law mandates insurance coverage for breast reconstruction.<o></o>

“Women should know that breast reconstruction is an option, and not just for wealthy women,” said Dr. Amy K. Alderman, an author of the study and an assistant professor at the. “Women should be able to talk to their health care provider about what those options are for them. And if their health care provider doesn’t bring it up, then women should do so themselves.” <o></o>

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Men are so interested in women's breasts why is it so difficult for them to understand that we might be just as interested in reconstructing them! I gather from the above, it helps a lot to have a female breast surgeon.

[Chelee]

Grace, Interesting article...thanks for sharing that with us. It wasn't long ago I asked on another board how many of the women had their surgeons or onc bring up the topic of breast reconstruction? I was interested because it was *never* mentioned to me. When I was first DX I was so overwhelmed with far too many other things that having reconstruction never even crossed my mind. (Wished it would of though.)

Now that its been a bit over a year I know more about it and that fact that our insurance *will* cover it. I wish someone would of brought it up to me...but not once did they. I only heard about it on this board and one other. I think its interesting that the article states that surgeons say 64% of their patients just aren't interested in it. (I wonder if that is really true?) Or could it be that the surgeons *never* even brought it up to their patient?

As it states in that article, & to be quite honest....when it all started for me I had no idea it was even an option for me. I think this should be mandatory that women are told about this from the get go. If they can find time to talk to you about which chemo trt you will have, radiation trts, and tell you about having a mastectomy. They can certainly find time to tell you about reconstruction I would think. (I'm sure many women did have good surgeons that brought this up at the beginning...but still far too many just don't cover it.)

Chelee

[tousled1]

It is true that insurance must pay for reconstruction. Also, you have up to three years to decide if you want reconstruction or not and still have insurance pay for it.

My surgeon (breast cancer specialist and a woman) referred me to a plastic surgeon after my initial visit with her. I saw the plastic surgeon and had an in-depth discussion about reconstruction. Due to the fact that we knew before hand that I would require radiation, I was told that I'd have to wait until at least six months after completion of radiation to have reconstruction.

[Linda]

I also found it interesting (offensive) that some plastic surgeons no longer do breast reconstruction, since it is covered by insurance (and therefore they make lower rates than patients will self pay for face lifts, etc.) Kind of scummy, isn't it, a ps who won't work on women who've had cancer.
L

[harrie]

Nov 2006, I had a bilateral mastectomy and at the same time had DIEP flap reconstruction, which is similar to the TRAM flap but they do not take muscle.
Maryanne