Only a small percentage of Canadian women appear to opt for breast reconstruction following mastectomy, despite the safety of the procedure and its positive effects on a patient’s self-esteem, researchers say.
Use of immediate breast reconstruction at the same time as mastectomy has increased in the U.S. but not in Ontario, says Dr. Toni Zhong, a plastic and reconstructive surgeon at Princess Margaret Hospital.
Only a small percentage of Canadian women appear to opt for breast reconstruction following mastectomy, despite the safety of the procedure and its positive effects on a patient’s self-esteem, researchers say.
In a review article in this week’s Canadian Medical Association Journal, Toronto researchers say there is a dearth of data on how many women in the country are currently having reconstructive surgery after mastectomy for breast cancer.
But rates in Canada have been historically low, said principal author Dr. Toni Zhong, a plastic and reconstructive surgeon at Princess Margaret Hospital.
An Ontario study in 1994-95 found a breast reconstruction rate of 7.7 per cent, while a 1991 analysis for Nova Scotia showed 3.8 per cent of women in that province had the procedure.
In contrast, rates were higher in Australia (almost 10 per cent in 1982), Denmark (14 per cent, 1999) and England (16.5 per cent, 2006). In the United States, breast reconstruction rates rose from as low as 3.4 per cent in 1985 to a high of 42 per cent in 1997 at specialized cancer centres.
Use of immediate reconstruction at the same time as mastectomy has also increased in the U.S., in part due to a recommendation by the Commission on Cancer of the American College of Surgeons in 2001 to incorporate the practice in the treatment of early-stage breast cancer.
“All I can say from this review is that this isn’t a topic that has been visited,” said Zhong. “At least in Ontario, this topic hasn’t been visited since the mid-1990s.”
National statistics on breast reconstruction aren’t kept, but Zhong and her colleagues are now trying to gather that information province by province.
“A lot of us have a hunch that maybe Canada is lagging behind what … (other) high-income countries are doing. But we don’t know.”
Research has shown that breast reconstruction performed at the same time as mastectomy for women with early-stage cancer is a “completely safe practice to do from a cancer perspective and it’s actually a good thing to do for patients because they get benefit from it,” she said.
Zhong said women tell her that having a breast surgically restored enhances their feeling of being whole and feminine.
“And I think when you look down and you don’t have the mastectomy scar and instead you have a fairly normal-looking breast mound, it’s less of a reminder that you went through this cancer treatment.
“It’s a sense that you’ve put this battle behind you.”
