More breast cancer survivors opting for reconstruction

For Stower, the decision to have reconstruction surgery was immediate. During almost a year of treatment that included four rounds of chemotherapy, followed by six weeks of radiation, she had spacers placed in her chest to stretch the skin and make room for the placement of the implants.

“Now that I’m healthy again, that part of my body sort of signals health,” says Stower, now 27 and working in Washington, D.C. “If I didn’t have reconstruction, it would be a permanent reminder that something was stolen.”

Under a 1998 federal law, most group insurance plans that cover mastectomies also cover breast reconstruction. The study published in the Journal of Clinical Oncology identified 20,506 women who had a mastectomy for breast cancer between the time the 1998 law passed and 2007. By looking at data from a nationwide employment-based database of medical claims, researchers found that 46% of women who underwent a mastectomy received breast reconstruction in 1998. The number rose to 63% by 2007.

Study author Reshma Jagsi, a radiologist and associate professor of radiation oncology at the University of Michigan Comprehensive Cancer Center, says the law and increased awareness could be driving the increase.

“Reconstruction is an important part of treatment for survivors,” she says. “It can have substantial benefits on women’s quality of life and improve their physical, mental and social life.”

While Stower says she felt lucky that she was able to receive treatment in Minneapolis, the study showed dramatic variation on reconstruction based on geographic location: Only 18% of women in North Dakota underwent reconstruction, while a high of 80% in Washington, D.C., did so.

“We are seeing the difference based on location is largely associated with the number of plastic surgeons in the area,” Jagsi says. “So the worry is women who don’t live in an area with many plastic surgeons don’t have adequate information or access to this treatment.”

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