If a woman has Medicaid or Medicare, she is less likely to have breast reconstruction surgery after a mastectomy, a University of North Carolina (UNC) Lineberger Comprehensive Cancer Center study has found.
In the study, researchers analyzed insurance claims information for 5,381 women who had Medicaid, Medicare or private insurance and were diagnosed with breast cancer. The women all had a mastectomy within six years of their diagnosis and kept their insurance plans for at least two years after the procedure.
The raw data showed that 56 percent of women with private health insurance received breast reconstruction while only 10 percent of women with Medicare and 11 percent of women with Medicaid received it.
After the researchers adjusted for factors such as age or the stage of disease, the results showed that women with Medicare were 42 percent less likely to have breast reconstruction than women with private insurance, and women with Medicaid were 76 percent less likely.
“We know that breast cancer affects not only the physical well-being of the patient, but also her psychosocial well-being, and we know that breast reconstruction can help address those issues,” said first author Dr. Michelle Roughton, an assistant professor of surgery and the program director for the UNC School of Medicine Section of Plastic and Reconstructive Surgery.
The researchers also found that distance played a part in whether a woman received breast reconstruction or not. For those who lived 20 miles or more from a surgeon, they were 27 percent less likely to get surgery, and those who lived 10 to 20 miles away from the surgeon were 22 percent less likely.
For patients who live far away from Roughton’s practice, she uses telemedicine for initial consultations, along with text and email to help her assess her patients after the procedure.
“These findings highlight the fact that there are more barriers to breast reconstruction access than we previously recognized,” she said.
