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Docs' Referral Practices Limit Breast Reconstruction

Findings show only 16% of U.S. women who've had mastectomy have plastic surgery

MONDAY, March 26, 2007 (HealthDay News) -- Low rates of breast reconstruction surgery in the United States may be partly due to major differences in plastic surgeon referral practices by general surgeons treating newly diagnosed breast cancer patients, a new study suggests.

Even though the procedure is covered by health insurance, breast reconstruction is done in only 16 percent of U.S. women who've had a mastectomy, according to background information in the study, which is published in the May 1 issue of Cancer. Previous research has suggested that age and race are factors in this low rate, and that doctors' referral and information-sharing habits may also have an impact.

The study of 456 general surgeons in Ann Arbor, Mich., and Los Angeles found that only 25 percent of them refer most of their breast cancer patients for a breast reconstruction consultation at the time of treatment planning.

Specifically, 44 percent of the general surgeons referred less than 25 percent of their eligible patients to a plastic surgeon for a breast reconstruction consultation, and 24 percent of surgeons referred more than 75 percent of eligible patients.

Female surgeons who did more than 50 surgeries a year and surgeons with clinical practices located in cancer centers were most likely to refer a high proportion of eligible patients, the study said.

Surgeons with low referral rates cited inadequate patient knowledge, high cost, and unavailability of plastic surgeons as reasons for not referring patients for a breast reconstruction consult. Many low-referral surgeons also said they believed that breast cancer patients regarded breast reconstruction as a low priority compared to other aspects of breast cancer management.

The study authors concluded that "there are systematic differences among surgeons with regard to referral to plastic surgeons prior to surgical decisions for breast cancer," and that the most significant barrier "to co-management may exist especially in smaller surgeon practices, which may have a more challenging patient mix and limited resources."

More information has more about breast reconstruction.

SOURCE: Cancer, news release, March 25, 2007
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