For women with breast cancer treated by surgical removal of the breast (mastectomy), surgery to rebuild the breast shape (breast reconstruction) is often used to improve the appearance of the breast post-treatment. Despite advances in surgical technique, however, immediate breast reconstruction is still used only for a small number of mastectomy patients.
According to BreastSurgANZ Quality Audit data, between 1998 and 2010, 8% of patients with invasive breast cancers (i.e. where cancers have grown into the surrounding normal breast tissue) treated by mastectomy received immediate breast reconstruction. This proportion increased over time and was affected by patient age (from 29% in women below 30 to 1% in those aged 70 or more).
Other factors which increase the odds of immediate breast reconstruction being performed included:
- high socio-economic status
- private health insurance
- being diagnosed through early detection methods (e.g. BreastScreen) rather than symptoms
- treatment at a metropolitan rather than inner regional treatment centre
- treatment by a surgeon who treats breast cancer more frequently (the higher the annual caseload of the surgeon, the higher the likelihood of immediate breast reconstruction)
- small tumour size (less than 10 mm)
- no cancer cells found in lymph nodes
- having tumours that receive signals from the hormone progesterone to promote growth (progesterone-receptor-positive) and, therefore, are able to be treated with hormone therapy
- more tumours within the breast
- tumours in more than one region of the breast
- tumours in both breasts
- not having chemotherapy prior to surgery
- not having radiotherapy or hormone therapy subsequent to surgery
- receiving treatment designed to cease hormone production by the ovaries (ovarian ablation)