4.7 Review

Persistent Disparities in Postmastectomy Breast Reconstruction and Strategies for Mitigation

Journal

ANNALS OF SURGICAL ONCOLOGY
Volume 28, Issue 11, Pages 6099-6108

Publisher

SPRINGER
DOI: 10.1245/s10434-021-10487-z

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Racial disparities in breast reconstruction for African American women exist in various aspects, including reconstruction rates, physician referral patterns, patient knowledge of reconstructive options, and risk factors for complications. Targeted research and strategies can help improve these disparities.
For many women, breast reconstruction is an essential component of the breast cancer care continuum after mastectomy. Despite postmastectomy breast reconstruction now being a standard of care, numerous studies over the past decade have documented persistent racial disparities in breast reconstruction rates, physician referral patterns, and patient knowledge of their reconstructive options. These disparities have disproportionately impacted women of color-most specifically, African American women. Recent data have revealed racial differences in patient comorbidities, informed decision-making satisfaction, and clinical outcomes after breast reconstruction. Explicitly, African American women have significantly more risk factors for complications and less baseline knowledge regarding reconstructive options than white women. With a recent heightened attention focused on social determinants of health, studies designed to improve these racial differences have demonstrated promising results through educational outreach to underserved communities, implementation of tailored legislation promoting inclusion, diversity, and equity, and encouragement of additional recruitment of ethnically underrepresented-in-medicine surgeons. This study uses a targeted review of the literature to provide a summary of racial disparities in breast reconstruction for African American women, with our perspective on opportunities for improvement.

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