Breast Cancer Patients Need the Right to Choose

Despite an increase of breast reconstruction procedures performed in 2008, nearly 70 percent of women who are eligible for the procedure are not informed of the reconstructive options available to them according to a recently published report. Newly released statistics by the American Society of Plastic Surgeons (ASPS) shows that there were more than 79,000 breast reconstruction procedures performed in 2008 ( a 39 percent increase over 2007.). But in spite of this increase, current research suggests that many breast cancer patients aren’t offered their reconstructive options at the time of their diagnosis. As a Plastic and Reconstructive Surgeon, my patients need informed choices no matter what procedures they might be interestedin.  In an informal survey of my patients  in Loudoun Virginia who have had breast reconstruction procedures from other surgeons, I have found that most patients were not informed of all the methods of breast reconstructions available.

Most patients were only given the options of breast reconstruction with breast implants or a breast reconstruction with their own tissue through a pedicled flap.  More sophisticated techniques such as reconstruction through a microvascular flapwere not offered.   Many patients are not offered the option of a microvascular DIEP or TRAM Flap reconstruction because it takes the most sophisticated techniques and the most technical experience.  And it is this last technique, that most insurance companies are decreasing their financial compensations for. “Women need to understand all of their options to make an informed decision,” said ASPS President John Canady, MD. “Those who are diagnosed should be immediately referred to a full team of physicians that can provide breast care, and plastic surgeons need to be included as part of that treatment team.”  This team should include their primary care physician, an oncologist, general surgeon, pathologist, radiologist, as well as a plastic surgeon. The ASPS is launching an ongoing effort to bring public awareness to breast reconstruction issues, including education, access, and a team approach. Because early involvement by plastic surgeons and other physicians can allow development of an optimum treatment plan for each individual patient, collaboration amongst specialties is essential.

This team approach allows for the patient to not only have the best chance at a cure from their breast cancer but the optimum opportunity to have an excellent cosmetic result.  It is also important that patients actively participate in their treatment. Though a common misconception, eligible patients should not assume that anyone other than a board-certified plastic surgeon affiliated with an accredited facility is qualified to perform breast reconstruction. While technology has made breast cancer diagnosis, treatment, and reconstruction better than ever, it does not negate the need for medical expertise within each specific area of care. 

Blog by Dr. Phillip Chang, M.D. :  Offices in Leesburg in Loudoun, Reston in Fairfax, and Winchester. 

Adapted from a Story by the American Society of Plastic Surgeons. About ASPS The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 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