There has been a dramatic increase in the number of women undergoing immediate breast reconstruction after mastectomy—and this increase correlates with an increase in the use of implants, according to the results of a study published in Plastic and Reconstructive Surgery.
For some women, treatment of breast cancer involves a single or double mastectomy (removal of one or both breasts). In order to restore the appearance of a breast, women may choose to undergo breast reconstruction after their mastectomy. Research suggests that immediate breast reconstruction can improve psychological wellbeing.
Breast reconstruction surgery has become increasingly refined and can be successfully accomplished in almost all women treated with mastectomy. The goal of breast reconstruction surgery is to create a breast that matches the opposite breast. This can be accomplished by using a breast implant alone, by actually reconstructing the breast with the patient’s own tissue, or by utilizing a combination of these two techniques.
Researchers used data from a national database to assess trends in immediate breast reconstruction after mastectomy between 1998 and 2008. The analysis included information on the type of reconstruction (autologous or implant) and factors associated with the reconstruction.
The results indicated that out of approximately 178,600 mastectomies, 51,400 were followed by immediate breast reconstruction. During the 10-year period, the rate of immediate reconstruction increased from about 21 percent to 38 percent. The number of autologous procedures (using the patient’s own tissue) remained relatively unchanged during that period; however, the number of procedures using implants increased dramatically—by about 11 percent per year. This correlates with a 203 percent expansion in the overall use of implants.
There were a variety of factors that may have influenced the increase in the rate of immediate reconstruction—including an increased rate of double mastectomies, which rose by about 17 percent per year during the 10-year study period due to an increased effort to prevent breast cancer in high-risk women. Women who underwent double mastectomy were twice as likely to undergo reconstruction with implants compared to their single mastectomy counterparts. Another factor was likely the 1998 Women’s Health and Cancer Rights Act (WHCRA), which ensured coverage for post-mastectomy reconstruction.
The researchers concluded that the increase in immediate reconstruction correlates with a paradigm shift away from autologous reconstruction to reconstruction with implants.
Albornoz CR, Bach PB, Mehrara BJ, et al. A paradigm shift in U.S. breast reconstruction: increasing implant rates. Plastic & Reconstructive Surgery. 2013;
Posted January 22, 2013