Persistent Racial Disparities in Post-Mastectomy Breast Reconstruction Despite ACA Efforts

Despite ongoing improvements in the rates of immediate breast reconstruction (IBR) following mastectomy, racial disparities in access to reconstructive surgery remain significant, even after the implementation of the Affordable Care Act (ACA). A comprehensive study published in Plastic and Reconstructive Surgery analyzes national data to assess the impact of the ACA on these disparities.

The study highlights that while overall IBR rates have increased across all racial and ethnic groups, disparities persist. Initially, before the ACA's full rollout (2005–2008), reconstruction rates varied notably: white patients had a rate of 35.1%, Asian patients 28.8%, Black or African American patients 22.3%, and American Indian or Alaska Native patients only 3.8%. Hispanic patients, in particular, had a reconstruction rate of 28%, which was lower than the 33.4% observed in non-Hispanic patients.

Post-ACA (2016–2022), there was a marked increase in reconstruction rates nationwide. The largest gains were among American Indian/Alaska Native and Black/African American populations, with increases of 27.6% and 24.2%, respectively, surpassing the 16.9% rise seen in white patients. Hispanic patients experienced a significant 25.8% increase, becoming more likely than non-Hispanic patients to undergo reconstruction.

However, despite these improvements, racial minority groups still face barriers. In recent years, the IBR rate among white patients stood at 52%, whereas it was 46.5% for Black/African American patients, 38.7% for Asians, and 31.4% for American Indian or Alaska Native individuals. Interestingly, Hispanic patients now have a higher reconstruction rate (56.6%) compared to non-Hispanic patients (45.7%), reflecting shifting patterns.

Researchers acknowledge limitations in their analysis, noting that multiple factors influence access to reconstructive surgery, including cultural, social, and personal reasons, which are complex and multifaceted. Nonetheless, the data highlights that legislative efforts like the ACA have contributed to increased reconstruction rates across all groups, yet disparities still persist. Addressing these gaps requires targeted interventions to ensure equitable reconstructive options for all breast cancer patients.

In conclusion, while legislative advancements have made progress, ongoing disparities emphasize the need for continued efforts to promote equitable healthcare access and outcomes in breast reconstruction post-mastectomy.

Source: Medical Xpress