Latinas less apt to have breast reconstruction

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Spanish-speaking Latinas are less likely than other racial groups in the United States to undergo breast reconstruction following mastectomy, according to study findings to be presented next month at the American Society of Plastic Surgeons meeting in Chicago.

In the study, the breast reconstruction rate for Spanish-speaking Latinas was 13.2 percent, significantly lower than the next lowest rate, 28.4 percent, seen in blacks.

"Spanish-speaking Latinas face many barriers to reconstruction," lead researcher Dr. Amy K. Alderman, from the University of Michigan, Ann Arbor, told Reuters Health. "Very few actually receive reconstruction at the time of the mastectomy. They don't know how to get it; they aren't able to see a plastic surgeon to discuss their options; but they appear to have as much desire for reconstruction as women of other racial/ethnic backgrounds."

The findings stem from a survey of 1338 women (response rate 71.3 percent) with early breast cancer. The survey was completed, on average, 9 months after breast cancer diagnosis.

Overall, 493 (36.8 percent) of the women had a mastectomy. The breast reconstruction rates were 35.9 percent for whites, 35.7 percent for English-speaking Latinas, 28.4 percent for blacks, and just 13.2 percent for Spanish-speaking Latinas.

Spanish-speaking Latinas were significantly less likely than the other racial groups to be satisfied with their surgical decision and more likely to face barriers to reconstruction.

Roughly 42 percent of Spanish-speaking Latinas regretted their surgical decision compared to just 9.0 percent of whites. Spanish-speaking Latinas were also less likely than whites to have a preoperative plastic surgery consult (19.3 percent vs. 42.9 percent) but more likely to want further information about reconstruction (45.9 percent vs. 22.0 percent).

"We need to ensure that all women, regardless of their racial/ethnic backgrounds, are adequately informed of all of their surgical options for breast cancer, including the option of reconstruction for mastectomy defects," Alderman emphasized.

She added that her team is now involved in a study looking at the impact a woman's significant other has on the surgical decision-making process for breast cancer, including reconstruction.