Recent data suggest fewer than 20% have immediate reconstruction after a mastectomy, despite improved surgical techniques and attempts to increase insurance coverage, says Amy Alderman, a plastic surgeon at the University of Michigan Medical Center in Ann Arbor.
A lack of information does not fully explain differences among women. Here are other reasons women don't have immediate reconstruction:
• Medical considerations. Other treatment priorities can delay reconstruction.
• Money. A 1998 federal law says any insurer that covers mastectomy must cover reconstruction. But with rising co-pays and more limited policies, insured women may pay more now, says two-time breast cancer survivor Missy Fish of St. Louis. She paid $205 for reconstruction of one breast in 1991 and $5,000 for the same procedure in 2005.
• Choice. Some women don't want it.
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