Insurance coverage and the distance to a doctor’s office affect the likelihood that breast cancer patients will have reconstructive surgery after breast removal, a new study finds.
Researchers analyzed data from nearly 5,400 women in North Carolina who were diagnosed with breast cancer between 2003 and 2006 and had breast removal (mastectomy) within six months of diagnosis.
Twenty percent had breast reconstruction surgery within two years.
Compared to patients with private insurance, those with Medicare coverage were 42 percent less likely to have breast reconstruction and those with Medicaid coverage were 76 percent less likely. Medicare and Medicaid are U.S. government health insurance programs.
The University of North Carolina researchers also found that compared to women who lived within 10 miles of a plastic surgeon’s office, those who lived 10 to 20 miles away were 22 percent less likely to have the surgery, and those who lived 20 or more miles away were 27 percent less likely.
Minority patients were 50 percent less likely than whites to undergo breast reconstruction, according to the study published in the August issue of the journal Plastic and Reconstructive Surgery.
As in previous research, this study found that older age, advanced cancer and radiation treatment were associated with a lower likelihood of breast reconstruction surgery.
“We know that breast cancer affects not only the physical well-being of the patient, but also her psychosocial well-being, and we know that breast reconstruction can help address those issues,” study first author Dr. Michelle Roughton said in a university news release.
“These findings highlight the fact that there are more barriers to breast reconstruction access than we previously recognized,” she said.
Roughton is an assistant professor of surgery and program director of the Division of Plastic and Reconstructive Surgery at the university’s School of Medicine.
The U.S. National Cancer Institute has more about breast reconstruction.