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Influence of Race, Insurance Status, and Accessibility on Immediate Breast Reconstruction Rates

By: Alanna M. Greaney
Posted: Tuesday, November 21, 2017

A new study from the Perelman School of Medicine at the University of Pennsylvania found that minority women are less likely to seek immediate breast reconstruction (IBR) than white women, regardless of their access to care and insurance status. These results were published in The American Journal of Surgery.

 Led by Paris D. Butler, MD, MPH, Assistant Professor of Plastic Surgery at the University of Pennsylvania, the study evaluated the rates of IBR across more than 65,000 women in 67 health service area levels, all of whom had breast cancer and then mastectomy. The study was further measured by access to plastic surgeons, insurance status, and race.

“We know that insurance status and the number of plastic surgeons in a given area affect reconstruction rates, but this is the first study to look at what happens when you control for both of those, and it shows the disparity exists on racial lines alone,” revealed Dr. Butler in a press release.

Unsurprisingly, there were fewer reconstructions in the areas with less access to plastic surgeons. When insurance status was factored in, the researchers found approximately 60% of privately insured patients would undergo reconstruction versus 20% of those with public insurance.

However, in areas with high ratios of plastic surgeons per patient, white women had IBR 59% of the time, versus 47% for Hispanic women; 42% for African Americans; and 41% for Asians, Pacific Islanders, and Native Americans. When examining race and insurance status data together, researchers found that white women living in areas with high access to plastic surgery, possessing private insurance, had reconstruction 84% of the time. The number drops to 65% for Hispanics; 60% for African Americans; and 58% for Asians, Pacific Islanders, and Native Americans.