Just a small minority of breast reconstructions performed in the United States utilize microsurgical techniques, according to a report in the May issue of Plastic and Reconstructive Surgery.

Researchers led by C.R. Albornoz, MD, of Memorial-Sloan-Kettering Cancer Center in New York City, analyzed information from a national database of nearly 16,000 women undergoing mastectomy at U.S. hospitals during 2008. They found that approximately 6,000 patients underwent immediate breast reconstruction. The overall reconstruction rate was about 38 percent, which is higher than a 24 percent rate reported in a study using the same database from 1999 to 2003. Another 1,300 women underwent delayed breast reconstruction.

Breast implants were the most common method of reconstruction, used in 60.5 percent of patients. Another 34 percent of reconstructions were done with conventional plastic surgery skin flaps. The remaining 5.5 percent were performed using advanced microsurgical flap techniques.

Microsurgical breast reconstruction was more likely to be used at teaching hospitals and in women with private insurance. It was also more frequently used for delayed versus immediate reconstructions, the study showed.

The study also gleaned some other insights about breast reconstruction methods.

• Younger women were more likely to undergo reconstruction with implants.
• Implants were also more likely to be used for Caucasian or Asian patients.
• Implant reconstruction was also more likely performed on women with higher incomes, and in U.S. regions other than the Northeast.
• Women in their 50s were more likely to undergo autologous reconstruction.

"The presence of disparities in care suggests that current decision making for breast reconstruction is not based solely on patient preference or anatomic features," the researchers conclude.

[Source: Plastic and Reconstructive Surgery]