A national study from England indicates that older women are often not offered immediate breast reconstruction following a mastectomy, even though guidelines state that surgeons should discuss reconstruction with all suitable patients and that it should be available at the initial surgical operation.
The findings suggest a need for clinicians to audit their own-and their organization's-decision-making processes around offering immediate breast reconstruction, and to deal with any age bias that may be present.
"Immediate breast reconstruction aims to improve the quality of life of women with breast cancer who have a mastectomy. It should be offered to women unless the cancer has spread too far or a woman is too unwell to have this major surgery," said Ranjeet Jeevan, lead author of the British Journal of Surgery study. "Our study found that while breast cancer clinicians considered these factors in younger women, immediate reconstruction was offered less often to older women with suitable tumours and who were fit enough for surgery. Clinicians should consider adopting a standardised assessment tool to identify all women suitable for reconstructive surgery."
Article: Association between age and access to immediate breast reconstruction in women undergoing mastectomy for breast cancer, R. Jeevan, J. P. Browne, C. Gulliver-Clarke, J. Pereira, C. M. Caddy, J. H. P. van der Meulen and D. A. Cromwell, British Journal of Surgery, doi: 10.1002/bjs.10453, published online 8 February 2017.