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Accessibility of breast reconstruction options for patients across West Virginia

Arrin Brooks, MD/PhD Kerri Woodberry, MD, MBA, FACS
West Virginia University
2023-01-31

Presenter: Arrin Brooks

Affidavit:
This is original research has never been published nor presented. The research is 95% the work of the resident.

Director Name: Kerri Woodberry

Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

Breast reconstruction (BR) has been shown to be a significant predictor of health-related quality of life in patients undergoing mastectomy. Following the enactment of the Women's Health and Cancer Rights Act, which mandates that health insurance plans provide full coverage for BR after oncological resection, rates of BR have increased. However, there remain many gaps in reliable access to this type of care, and less than half of patients who undergo mastectomy receive BR. One notable discrepancy in BR rates is rurality, with patients coming from rural areas undergoing fewer reconstructions than those from urban environments. We sought to evaluate the accessibility of BR in West Virginia (WV) from a patient's perspective. As internet resources are a frequently used modality for patients to acquire healthcare-related information, we searched the material provided regarding BR at every hospital website across WV. All listed surgical services and physician directories were reviewed for plastic surgeons and services provided. Websites were then searched using terms: plastic, plastic surgery, breast, breast reconstruction, and microsurgery. Of the 64 hospitals in WV, 48 offer adult surgical services. Of those 48, we found that just 6 (12.5%) WV hospitals have public website-accessible information on BR at their institution, and only 5 (8.3%) hospitals mention microsurgery/autologous options on their websites. Further, none of the 7 WV hospitals that list plastic surgeons on their physician directory are in rural counties. In a state with a population of nearly 1.8 million, this likely poses geographic and financial barriers to patients desiring BR.

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