Recently released data from the American Society of Plastic Surgeons have summarized cosmetic and reconstructive procedures performed in 2016. According to these statistics, the total number of reconstructive procedures by ASPS member surgeons has remained relatively stable at 5.8 million annually since 2015. The vast majority of these procedures include tumor removal such as office-based skin cancer excision.
The American Cancer Society estimates that 252,710 new cases of invasive breast cancer will be diagnosed in the United States in 2017. The quality-of-life and psychosocial benefits of reconstruction after mastectomy are well known. Breast reconstruction accounted for 109,256 procedures in 2016 or 1.9% of all reconstructive procedures. We have observed steady annual growth in breast reconstruction over the years with 39% increase in procedural volume since 2000 and 3% increase since 2015. Many plastic surgeons have noticed a concurrent rise in patient-driven requests for bilateral mastectomy with immediate breast reconstruction. Today there are more than 3.1 million breast cancer survivors in the United States, many of whom may be candidates for delayed breast reconstruction or revisions of prior reconstruction.
Less than half of all women who require mastectomy are currently offered breast reconstruction surgery, and fewer than 20% elect to undergo immediate reconstruction. Studies have revealed that 23% of women understand the wide range of breast reconstruction options available. The Breast Cancer Patient Education Act (BCPEA) was signed by President Obama in December 2015 and implemented in October 2016 to inform breast cancer patients about the availability and coverage of breast reconstruction and prostheses. Although breast reconstruction has increased over time, there is still wide geographic variability associated with plastic surgeon density. Important studies are beginning to elucidate how cultural preferences and access to care may influence the decision to pursue breast reconstruction. Comprehensive and appropriate patient education remains paramount in our mission to deliver the best possible care, and geographical disparities in breast reconstruction remain clear opportunities for improvement.
It is vital to consult with a plastic surgeon certified by the American Board of Plastic Surgery, and preferably one who is a member of the American Society of Plastic Surgeons and held to the strictest standards in terms of ethics and patient safety. Due to the individual nature in choosing the type and timing of breast reconstruction, it is important for plastic surgeons to be involved early in the multidisciplinary treatment of breast cancer.