Few Surgeons Refer for Reconstruction -- MEDICA - World Forum for Medicine

The finding may help explain the consistently low number of women who pursue breast reconstruction after mastectomy. The researchers surveyed 365 surgeons. The study found 44 percent of the surgeons referred fewer than a quarter of their patients to a plastic surgeon prior to the mastectomy. Only 24 percent of surgeons referred three-quarters or more of their patients for reconstruction.

"Women may be more inclined to choose mastectomy with a good understanding of the reconstructive options. We need to help patients through this difficult decision-making process up front, through patient decision aids that include information about reconstruction and multidisciplinary approaches to care, where all surgical options are fully explained," says lead study author Amy Alderman, M.D., M.P.H., assistant professor of plastic surgery at the University of Michigan Medical School.

Fewer than 20 percent of women who could have breast reconstruction choose to undergo the procedure. In the current study, the surgeons attributed low rates of reconstruction to patients not wanting the procedure: 57 percent of surgeons said it was not important to patients, 64 percent thought patients were not interested and 39 percent thought patients were concerned that reconstruction takes too long.

Surgeons who referred fewer patients to plastic surgery were more likely to identify patient barriers such as inadequate knowledge, cost concerns and availability of plastic surgeons, compared to surgeons who referred the majority of their patients for reconstruction. The surgeons most likely to refer their patients to a plastic surgeon tended to be female, with a large volume of breast cancer patients. They were also more likely to work in a cancer center rather than a community hospital or teaching hospital.

MEDICA.de; Source: University of Michigan Health System