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One-Third of Physicians Don't Offer Breast Recontstruction Referrals to Breast Cancer Patients, ASPS Study Says

Lack of Knowledge and Misinformation About the Procedure Cited

For Immediate Release: December 17, 2002

ARLINGTON HEIGHTS, Ill. - One-third of referring physicians do not offer their breast cancer patients referrals for breast reconstruction, according to a study in a recent issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). Despite studies documenting the positive effect breast reconstruction has on a woman's quality of life, the percentage of women having the procedure remains surprisingly low, the study noted.

"Many breast cancer patients who would benefit from breast reconstruction are not being referred to plastic surgeons for the procedure," said Mitchell Brown, MD, ASPS member and co-author of the report. "In many cases the 'referring' physician treating the cancer is unaware of the options or has inadequate information about breast reconstruction and who would make an appropriate candidate."

According to the study in which 700 referring physicians were surveyed, one-third of physicians - oncologists, primary care physicians, and general surgeons - reported that they were not offering their breast cancer patients referrals because they had inadequate knowledge about the procedure. More than one-third of physicians indicated a belief that breast reconstruction delays the detection of cancer recurrence and interferes with cancer treatments. To date, no evidence exists to support these concerns, the authors noted.

The study also found that physicians were less likely to offer patients older than 49 years old breast reconstruction referrals, despite the fact that plastic surgeons do not exclude patients because of age. The reasons for this are unknown, but the authors suggest that the need for a reconstructed breast may be viewed as "less important" for older patients or physicians may perceive older patients as unsuitable candidates for breast reconstruction. The gender and personal beliefs of the physician also affected which patients received referrals to plastic surgeons for breast reconstruction.

Breast reconstruction after mastectomy has been shown to improve patients' body image and self-esteem, decrease psychological distress, restore a sense of femininity, and improve overall sexuality, the authors noted. According to ASPS statistics, 81,729 women had breast reconstruction in 2001.

"Our results indicate physician knowledge about breast reconstruction plays a major role in determining whether patients are referred for the procedure," said Dr. Brown. "We feel that a stronger emphasis should be placed on breast reconstruction during residency training and through continuing medical education programs. These programs would be beneficial to physicians as well as the women who have mastectomies."

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.