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The low use of breast reconstruction after mastectomy
The low use of breast reconstruction across the U.S. (16%) since the passage of the Women’s Health and Cancer Rights Act was an unexpected finding since it was believed that the lack of insurance coverage for these procedures prohibited women from receiving care. In addition, the national rate seems low to us as 40% of our patients choose immediate breast reconstruction, and that rate would undoubtedly be higher if our radiation oncologists were less aggressive. More importantly, the wide variations in use of breast reconstruction by geography and patient race concerns us that factors other than patient choice are driving current practice patterns. We need to further explore issues such as patients’ preferences for breast reconstruction across different races and ethnicities, referring physicians’ attitudes towards reconstruction, and women’s access to reconstructive surgeons. In summary, we need to determine what is the ‘right’ rate of breast reconstruction, especially for women of different cultural backgrounds.
Bibliographical reference:
Amy Alderman Department of Surgery, University of Michigan, Ann Arbor, USA
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