American Indian and Alaska Native (AI/AN) women with breast cancer are significantly less likely to undergo breast reconstruction after mastectomy compared to non-Hispanic White women, according to a new study published in Plastic and Reconstructive Surgery.
Researchers analyzed data from the National Cancer Database, examining 1,980 AI/AN women and 414,036 non-Hispanic White women who had mastectomies between 2004 and 2017. While reconstruction rates increased for both groups over the study period, AI/AN women remained nearly 50% less likely to have the procedure.
Dr. Jane Hui of the University of Minnesota, the study’s lead author, emphasized the need to understand Native women’s perspectives on breast reconstruction. “It will be essential to also determine Native women’s opinions related to breast reconstruction,” she said.
The study found that AI/AN women faced several disadvantages, including higher rates of comorbidities, greater reliance on public health insurance, and were more likely to have single-breast mastectomies. Other factors associated with lower reconstruction rates included older age, earlier diagnosis year, more advanced cancer, and living in areas with lower educational attainment.
Researchers noted that AI/AN women face numerous health disparities, including chronic underfunding of the Indian Health Service, implicit bias, and strained relationships with healthcare providers. The study suggests that multidisciplinary efforts to improve care delivery and earlier diagnosis could help reduce disparities.
Dr. Hui and her colleagues called for qualitative research into AI/AN perspectives on breast cancer care to improve shared decision-making and empower Native women in their choices regarding post-mastectomy reconstruction.
See “Study finds lower rates of breast reconstruction among American Indian/Alaska Native women” (July 2, 2024)
