Debate rages on life following breast cancer

More women choosing to 'go flat,' skip reconstructive surgery after mastectomies

Many more women are now opting to forego reconstructive surgery after having their breasts removed.

Even though insurance would pay for the operation.

Even though reconstruction long has been the standard, with more than 60 percent of eligible women choosing it (106,000 of the procedures were done last year). 

And even though, according to an article by Roni Caryn Rabin in The New York Times last week, most "plastic surgeons and oncologists aggressively promote breast reconstruction as a way for women to 'feel whole again.'" 

"Going flat" certainly has become a more publicized choice.

Why? 

Dr. Deanna J. Attai

The Times article quotes Dr. Deanna J. Attai, a past president of the American Society of Breast Surgeons (ASPS), to the effect that "Reconstruction is not a simple process. Some women just feel like it's too much: It's too involved, there are too many steps, it's too long a process." 

The "nascent movements to 'go flat' after mastectomies," the piece continues, "challenges long-held assumptions about femininity and what it means to recover after breast cancer" — and flies in the face of the fact that "women's health advocates fought for and won approval of the Women's Health and Cancer Rights Act of 1998, which requires health plans to cover prosthetics and reconstructive procedures."

Rabin's story contends that "up to one-third of women who undergo reconstruction experience complications."

And that "a systemic review of 28 studies found that women who went without reconstruction fared no worse, and sometimes did better, in terms of body image, quality of life and sexual outcomes."

According to the article, Dr. Clara Lee, an associate prof of plastic surgery at Ohio State University who performs the procedure, says "the dirty little secret of breast construction" is that the "risk of a major complication is higher than for the average elective surgery."

In contrast, Dr. David H. Song, chief of plastic surgery at the University of Chicago and the immediate past president of the ASPS, is quoted as saying that focusing on the risk of complications is like focusing on plane crashes when millions of flights land safely.

Both pros and cons of reconstructive surgery are touched upon in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.