Retrospectacle: A Neuroscience Blog

UM Hospital has an excellent cancer facility, and as breast cancer is the most common form of cancer in women, many cases of breast cancer are treated here at UM. However, many post-operative women choose not to go through breast reconstruction. Why?

A study here at UM (Comprehensive Cancer Center) discovered that 44% of surgeons (n = 365) do not refer the majority of their patients to a plastic surgeon for breast reconstruction. Only 24% of surgeons reported referring 3/4 or more of their patients for reconstruction.

Furthermore, less than 20% of women who could qualify for breast reconstruction undergo the surgery. In the study, published in this month’s edition of the journal Cancer, 57% of surgeons reported they believed breast reconstruction was not important to their patients, 64% believed their patients were not interested, and 39% thought patients were concerned reconstruction would take too long. About half of the surgeons indicated that they thought their patients were concerned that reconstruction would cost too much, despite a 1998 federal law which mandates breast reconstruction be covered by insurance.

The surgeons most likely to refer their patients to a plastic surgeon tended to be female, with affleunt patients, and to practice in settings where many plastic surgeons were available.

Comments

  1. #1 dan dright
    March 27, 2007

    Shelly,

    Do the doctors give specific reasons why they don’t refer patients? Do insurance companies subtly (or not-so-subtly) tell them not to? This seems very sad to me.

  2. #2 dan dright
    March 27, 2007

    In response to my stupid and illiterate self:

    57% of surgeons reported they believed breast reconstruction was not important to their patients, 64% believed their patients were not interested, and 39% thought patients were concerned reconstruction would take too long.

    The second part of my question and my sadness still stand, however.

  3. #3 Shelley Batts
    March 28, 2007

    Yes, Dan, I agree its sad. I would hope that insurance companies aren’t interfering in any way, which would be illegal. I hope the study will at least bring the issue to doctors’ attention that there are options which should be presented.

  4. #4 knobody
    March 28, 2007

    i wonder if the age of the patients is a factor. i have two friends who have undergone breast cancer treatment in the last two years and reconstruction was just an assumed part of the process for both of them. they are both in their 30’s. i have to wonder if some doctors think that younger patients will want reconstruction by default while older ones might just want treatment to be over and done with as reconstruction can add six months to a year on to the whole ordeal.

  5. #5 Lab Lemming
    March 29, 2007

    Is breast cancer really more prevalent than lung cancer or melanoma (OK, maybe melanoma isn’t that huge up in the bitter North)?

  6. #6 Jesmi
    September 6, 2007

    Thank you for the suggestions.

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