African American Women Less likely to Receive Breast Reconstruction After Mastectomy

Majority of the African American women who undergo mastectomy are 55 percent less likely to receive breast reconstruction, a practice that has increased dramatically in recent times.

Breast reconstruction is rebuilding of breast surgically in those women who have had a breast removed. This surgery helps women feel more comfortable. It is done after mastectomy and is linked with enhanced quality of life and other benefits. The insurance coverage for reconstruction is legislatively mandated.

A recent study by researchers at the University of Michigan Comprehensive Cancer Center found that in 1998 just 46 percent of the patients received reconstruction and this number dramatically increased to 63 percent by 2007.

But a team of Dartmouth researchers found that nearly 55 percent of the African American women were less likely to get a breast reconstruction done after mastectomy irrespective of where they received their care. The study has filled a gap in addressing the issue as to whether racial disparities in breast reconstruction were due to disproportionate use of hospitals with services available.

"We wanted to understand whether the racial disparity observed in breast reconstruction among women with breast cancer was related to where women received care, independent of race," said Tracy Onega, PhD, Associate Professor of Community & Family Medicine, Norris Cotton Cancer Center, and The Dartmouth Institute for Health Policy and Clinical Practice, The Geisel School of Medicine at Dartmouth.

The researchers noticed that the lower likelihood for breast reconstruction for women of all races was observed for those attending hospitals. In rural regions the women were 67 percent less likely to undergo breast reconstruction when compared to those in urban areas. When compared to the teaching staff, the non-teaching staff was less likely to avail the surgery. Though the effect of hospital type on breast reconstruction is significant, the African American and Caucasian women did not vary in their use of hospital.

"The next step is to understand which factors contribute to the disparity," said Onega. "We want to understand whether these factors are economic (although all women studied were insured by Medicare), cultural, behavioral, etc. so that we can begin to develop targeted interventions for all women who would prefer to have reconstruction after mastectomy, to increase their quality of life and well-being."

The finding was published in the SpringerPlus.