Saturday, April 12, 2014

The Reconstruction Era – Part 11


http://www.breastreconstructiondc.com/NAV09/header1.jpg

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

“It appears that the next event is breast reconstruction!”

While it may seem an obvious choice to some who are outside of the breast cancer community (is there ANYONE who is?) breast reconstruction is not an easy choice.

After months that include radical mastectomy, chemotherapy, hair loss, and recovery, the decision to “go under the knife” again is not one that women take lightly.

Even so, new research shows that more and more women are undergoing the procedure to rebuild what was once there. “Researchers found that 46 percent of patients received reconstruction in 1998 but that figure rose to 63 percent by 2007.

While this article was informative, from a layperson’s point of view, I find the authors somewhat narrow-minded – perhaps even “ignorant” – about certain things, and that bothers me.

For example, “The study also revealed dramatic variation in reconstruction based on geographic region, from a low of 18 percent in North Dakota, to a high of 80 percent in Washington, D.C. This was largely associated with the number of plastic surgeons working in each state…Any time we see geographic variations in practice patterns, we worry that care is not being appropriately individualized and that patients are not being offered all their options. It’s important to make sure women have all the information they need about breast reconstruction and are aware that it is an option...” (emphasis mine)

REALLY? REALLY? Have any of the authors even visited North Dakota? Clearly not! I actually have friends from ND – and some from DC. As a whole, ND is a very conservative state with a preponderance of farmers and has a frontier attitude. A “I can take it” sort of way of looking at the world. I would say THIS has a larger effect on the number of women getting reconstruction after mastectomies than “the number of plastic surgeons”. Did the authors consider that the attitude of your average NoDak would drive out plastic surgeons; they’d be seen as superfluous parasites. And DC’s plastic surgeons? REALLY? REALLY? In a city where the highest rollers are broadcast nationally and internationally with close-ups and in press conferences on a minute-by-minute basis, plastic surgeons would FLOCK there to make sure our politicians look pretty on TV and in webcasts!

That seems such a no-brainer, it makes me wonder about the rest of the study.

This seeming blindness brings into question another statement: “The researchers also note that more women are receiving implants rather than recreating breasts using tissue from other parts of their body, called autologous reconstruction. Autologous techniques tend to deliver better cosmetic results and higher satisfaction, but it’s a time-consuming, demanding operation that requires a longer hospital stay and recovery time. The researchers raise concern that current medical reimbursement discourages surgeons from offering autologous reconstruction.

REALLY? Choosing a long, difficult surgery with a lengthy recovery time after…a long difficult surgery with a lengthy recovery time doesn’t seem a natural aversion-reaction by breast cancer survivors and can be more sensibly ascribed to INSURANCE COMPANY PRESSURE????

Hmmm. My further comment here would be that perhaps the authors – maybe even more breast reconstruction plastic surgeons – should cast more widely when interpreting their research data. Even so, the update on the subject was reasonable and even though the interpretation was narrow-minded, the DATA was sound.

No comments:

Post a Comment