Dr. Schneider believes that raising awareness of the risks and benefits associated with breast reconstruction will allow more women to make an informed decision, according to Reuters Health News. He and Dr. Mehrara reviewed previous studies on breast reconstruction to understand what influenced these women to choose not to undergo breast reconstruction, which was recently published in Medscape. The researchers concluded that less than 40 percent of women in the United States choose to undergo immediate breast reconstruction after radical breast cancer surgery, and that these women do not care whether they undergo breast reconstruction. Instead, researchers found that women who opted for reconstruction had significantly better mental health, social functioning and physical imagery than those who did not. Whether or not breast reconstruction represents a victory over cancer can vary in the minds of women from different backgrounds. The latest study found that women’s decision to undergo reconstructive surgery was more dependent on age, race, and socioeconomic background than on whether the doctor mentioned reconstructive surgery at the first visit. The researchers noted that some physicians’ views may be somewhat outdated: more than one-third of breast cancer surgeons in 1998 believed that reconstruction might delay detection of cancer recurrence; 17 percent believed that reconstruction was associated with a high incidence of complications. Some physicians are concerned that immediate breast reconstruction may delay the start of chemotherapy, but several retrospective studies have found that breast reconstruction does not have a significant impact on the timing of chemotherapy after radical breast cancer surgery; reconstruction may increase the chance of breast cancer recurrence and delay the detection of new tumors. However, several large studies covering 20 years have found that reconstruction does not increase the chance of breast cancer recurrence, and previous studies have found that reconstruction does not delay the diagnosis of new malignancies. In addition, immediate breast reconstruction has the advantage of reducing the number of procedures. When patients choose immediate reconstruction, the cosmetic results are often superior when normal skin is preserved and filler material is used to contour the breast. For some women, there is also psychological comfort, which is important in terms of their body imagery and the feeling of being a woman. In large academic medical centers or facilities with trained plastic surgeons, most women still want the option of immediate reconstruction after a mastectomy. However, such services are not ubiquitous, and patients treated in rural areas are not able to undergo immediate breast reconstruction. Black patients with lower levels of education or significant medical problems other than cancer are less likely and less likely to undergo reconstruction, Dr. Morrow said. In addition, some patients with simple mastectomies are reluctant to undergo reconstruction, and others may turn to breast-conserving surgery. As a physician it can be easy to assume that the most powerful things are the hand and the knife, but it is more important to make a judgment about prognosis and to help patients with how they choose.