Health experts have long known that white women are more likely to have breast reconstruction after mastectomy than their minority counterparts. A new study from the Perelman School of Medicine at the University of Pennsylvania shows that is true, but not for the reasons most experts believed.
Specifically, white women were found to be:
Lead author Paris D. Butler, MD, MPH and his team analyzed surgery databases from California, Florida, and New York from 2008 through 2012. (These three states combined account for about 24% of the U.S. population, according to the 2010 census.) The team first identified more than 65,000 women who had mastectomy to treat breast cancer; they then separated these women into two groups: those who had breast reconstruction and those who did not. The women were also grouped by race, insurance status and access to plastic surgeons.
Some of the findings were not surprising. As expected, for example, having less access to plastic surgeons led to fewer reconstructions, and far more women who were privately insured had breast reconstruction compared to those with Medicare or Medicaid (60% vs 20% respectively), regardless of race.
What was surprising, though, was that the availability of plastic surgeons and the type of health insurance didn’t seem to be a factor in the lower rates of reconstruction.
The findings of this study suggest that race alone, not geography or socioeconomic status, is a primary predictor of women who do or do not choose breast reconstruction. The study authors identified four areas of improvement that can help minority women better understand their post-mastectomy options and advocate for themselves to reduce the disparity:
Resource: Butler PD, Familusi O, Serletti JM, et al. “Influence of race, insurance status, and geographic access to plastic surgeons on immediate breast reconstruction rates.” The American Journal of Surgery, 2017 Nov 3 (epub ahead of print).