Semin Plast Surg 2004; 18(2): 149-155
DOI: 10.1055/s-2004-829049
Published 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.

Breast Reconstruction Practices in North America: Current Trends and Future Priorities

Edwin G. Wilkins1 , 2 , Amy K. Alderman1
  • 1Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical Center, Ann Arbor, MI
  • 2VA Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, MI
Further Information

Publication History

Publication Date:
14 June 2004 (online)

The Women's Health and Cancer Rights Act (WHCRA) became federal law on January 1, 1999, mandating health care payer coverage for postmastectomy breast reconstruction. Despite passage of this legislation, breast reconstruction rates in the United States remain low. The Surveillance, Epidemiology and End Results (SEER) database for mastectomy patients in 11 regions across the United States show overall rates for immediate and early delayed reconstruction (performed within 4 months of mastectomy) of 15.4% for 1998 and 18.0% for 2000. Reconstruction rates vary significantly by region as well as by patient age, race, and income. The paper examines potential etiologies for low utilization of breast reconstruction and outlines possible remedies.


Edwin G Wilkins

Section of Plastic Surgery, Department of Surgery, University of Michigan Medical Center

1500 E. Medical Center Drive, 2130 Taubman Center

Ann Arbor, MI 48109