Autologous Breast Reconstruction and Racial Disparity
14 Sep 2016
As part of our African American breast cancer focus with BWHI this month, we’re taking a look at breast reconstruction and racial disparity. African American women are twice as likely as Caucasian women to choose autologous breast reconstruction. Autologous breast reconstruction is a procedure that uses the woman’s own tissue to reconstruct the breast form. The tissue is taken from another part of her body.
Plastic and Reconstructive Surgery is a medical journal published by the American Society of Plastic Surgeons (ASPS). An article in the August 2016 issue of the journal tackles some of the data from the study of over 2,500 women.
The racial makeup of women in the study was as follows: 14% African American, 82% Caucasian and 4% other races.
An article in Breast Cancer News goes further into the study by ASPS Member Surgeon Terence Myckatyn, MD; Ketan Sharma, MD, MPH; and their colleagues at Washington University School of Medicine, St. Louis.
The scientists analyzed data collected from a study of 2,533 women, between 2000 and 2013, who underwent first-time autologous (versus implant-based) reconstruction following mastectomy.
Information that they collected for the study included age, smoking, diabetes, obesity, provider, race, pathologic stage, health insurance type, charge to insurance, and socioeconomic status.
The study showed that 67%, or 1,687 of the women in the study, chose implant-based reconstructive surgery. It showed that 18%, or 455 women chose autologous reconstruction. Fifteen percent, or 391 patients, were unknown.
The final results of the study showed African American women had a higher rate of autologous breast reconstruction. Only 17% of Caucasian women had autologous breast reconstruction in comparison to 23% of African American women.
“African-American race remains the most clinically significant predictor of choice of autologous-based breast reconstruction, even after accounting for other important characteristics,” according to the study.
The data also revealed African American women were more likely to have Medicaid insurance coverage. They were also more likely to live in a low-income area. These women also had higher rates of smoking, obesity, and diabetes.
Circumstances for the Caucasian women showed they were not as likely to be in the same situation.
At the end of the day when adjustments were made for all of these differences, African American women were still greatly identified with autologous reconstruction. African American women, the study concludes, are about twice as likely to choose autologous reconstruction, “independent of other factors.”
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