Breast reconstruction after mastectomy: who seeks it, who refuses?

Recent Food and Drug Administration hearings on silicone gel implants have drawn attention to the paucity of information about women who seek reconstruction after mastectomy compared with those who do not. New analyses of data gathered in the early 1980s address this issue. Three groups of mastectomy patients were compared: 117 women who sought and obtained delayed reconstruction, 26 who sought but decided against delayed reconstruction, and a comparison group of 53 who were not seeking reconstruction. Results indicated that although younger and more knowledgeable about reconstruction, patients in the reconstruction group were similar to those in the comparison group. However, the women who sought but chose not to proceed with reconstruction appear to have been at greater risk for physical and emotional disappointment with the results of reconstruction, which suggests that poor candidates for reconstruction may select themselves out at the time of consultation.