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Mastectomy patients not being referred to plastic surgeons, study finds

Ann Arbor, Mich. — A recently released study says that more than 40 percent of surgeons do not refer most of their breast-cancer patients to a plastic surgeon prior to the initial surgery, when the woman is choosing her treatment course.

The study’s researchers, from the University of Michigan Comprehensive Cancer Center, say their finding may help explain the low number of women who seek breast reconstruction following a mastectomy.

The study appeared March 26 in the online edition of the journal Cancer.

The researchers surveyed 365 surgeons, asking them how often they referred patients considering a mastectomy to a plastic surgeon before performing the mastectomy. Forty-four percent of the surgeons referred less than a quarter of their patients to a plastic surgeon prior to the mastectomy. Only 24 percent of the surgeons said they referred three-quarters or more of their patients for reconstruction.

The researchers write, “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.”

The study says 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. In addition, nearly half of the surgeons felt patients were concerned about the cost of reconstruction — this despite a 1998 federal law mandating insurance coverage for reconstructive breast surgery.

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