The New York Times recently published a piece on disparities in breast cancer treatment among black and white women. Citing research from the University of Pennsylvania that was published in the Journal of the American Medical Association, the article describes how white women with breast cancer live three years longer than black women. The five-year survival of white women was almost 70%, but only 56% for black women.
Why? The research attributes this disparity to later detection of cancer, less access to health care, and poorer quality of health care for black women.
Racial disparities in health care are not just disconcerting, but they are also quite complex. This research does not even begin to touch on the racial and ethnic disparities in breast cancer reconstruction-- the procedure plastic surgeons perform to recreate breasts in women who have mastectomies. Previous researchers have shown that less "acculturated" or assimilated Latina populations are unlikely to undergo breast reconstruction (Journal of Clinical Oncology), and that African American women are more likely to forgo reconstruction in favor of using "what God has given me" (Journal of Health Psychology).
Women of all backgrounds should remember that breast reconstruction is just as medically necessary as breast cancer surgery. The federal government passed the Women's Health and Cancer Rights Act in 1998 to make this into law: if your insurance company covers your breast cancer surgery, it is REQUIRED to cover your breast reconstruction. Reconstruction can include breast implants, breast lifts, using your own tissue to make a new breast, and surgery on the other breast to make sure you look symmetrical and balanced.
As a plastic surgeon, I strongly believe that breast cancer detection saves lives, and that breast cancer reconstruction can profoundly rebuild a women's sense of femininity after surgery. However, as these studies demonstrate, both awareness and cultural competence are needed to improve each woman's ability to make the decision that is right for her. Doctors should support their patients navigate these waters every step of the way.
Click the video above to watch singer-songwriter Jewel's public service announcement on breast reconstruction after cancer.