Trends in Postmastectomy Breast Reconstruction in the United States

By: Chris Schimpf, MSW
Posted: Monday, March 17, 2025

Rates of postmastectomy breast reconstruction appear to have stabilized in the United States, according to the results of a study published in the journal Plastic and Reconstructive Surgery. Jonas A. Nelson, MD, MPH, of Memorial Sloan Kettering Cancer Center, New York, and colleagues found the steady increases observed following the 1998 passage of the Women’s Health and Cancer Rights Act seem to have subsided, and some socioeconomic disparities appear to have improved. The researchers stressed the need for further study to gain a better understanding of these shifts.

“Our analysis of U.S. national databases shows that rates of immediate breast reconstruction have stabilized over the past decade,” said Dr. Nelson in a press release issued by the publisher. “In addition, previously documented disparities based on race and insurance also appear to have decreased—albeit slowly—with a more equitable distribution of postmastectomy breast reconstruction.”

A total of 1,554,381 patients who underwent mastectomies between 2005 and 2017 were included in this longitudinal analysis, drawn from the National Surgical Quality Improvement Program (NSQIP) database, the Surveillance, Epidemiology, and End Results (SEER) Program database, and the National Cancer Database (NCDB). Among the participants, 32.7% underwent breast reconstruction.

The investigators reported that annual reconstruction rates per 1,000 mastectomies increased from 2005 to 2012 (NSQIP incidence rate ratio [IRR] = 1.077; SEER Program IRR = 1.090; NCDB IRR = 1.092) and stabilized between 2013 and 2017. In addition, NCDB data showed that patients who were aged 59 or younger, privately insured, had fewer comorbidities, and underwent contralateral prophylactic mastectomy were more likely to undergo breast reconstruction (all P < .001). They also observed that the increase in rates of breast reconstruction was higher among Black (252.3%) and Asian (366.4%) patients than among White patients (137.3%). Finally, rates of breast reconstruction were found to have increased more among patients with Medicaid (418.6%) and Medicare (302.8%) than among privately insured patients (125.3%).

Disclosure: For full disclosures of the study authors, visit journals.lww.com.

Plastic and Reconstructive Surgery

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