Are American Indian/Alaskan Native Women Likely to Have Postmastectomy Breast Reconstruction?

By: Bryna Goeking
Posted: Monday, August 5, 2024

American Indian/Alaska Native women with stage 0 to III breast cancer seem to have lower rates of breast reconstruction following mastectomy compared with non-Hispanic White women, according to a recent literature review cohort study of the National Cancer Database. Jane Y.C. Hui, MD, MS, of the University of Minnesota, Minneapolis, and colleagues published their findings in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. Their findings demonstrated an independent association between American Indian/Alaska Native race and lower rates of breast reconstruction across 13 years.

“Despite an upward trend in reconstruction, American Indian/Alaska Native women continue to be less likely to undergo breast reconstruction,” Dr. Hui said in a press release. “While our findings point to some possible approaches to reducing this disparity, it will be essential to also determine Native women’s opinions related to breast reconstruction.”

Meeting study inclusion criteria were 414,036 non-Hispanic White and 1,980 American Indian/Alaskan Native women who had mastectomy for breast cancer between 2004 and 2017. Non-Hispanic White women had lower rates of other medical diagnoses, were less likely to have public health insurance, and less likely to undergo unilateral mastectomy than their American Indian/Alaskan Native counterparts.

Over the 13-year study period, annual rates of breast reconstruction after mastectomy for stage 0 to III breast cancer increased from 13% to 47% for American Indian/Alaska Native women and from 29% to 62% for non-Hispanic White women. Race remained independently associated with lower odds of breast reconstruction, as well as older age, advanced stage of disease, and presence of comorbidities.

“Qualitative research into American Indian/Alaskan Native perspectives on breast cancer care could improve shared decision-making between physicians and American Indian/Alaskan Native patients, empowering American Indian/Alaskan Native women to choose postmastectomy reconstruction if they so desire,” concluded the study authors.

Disclosure: The study authors reported no conflicts of interest.

Plastic and Reconstructive Surgery

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