Latest News 13 August 2020 | Research showing Maaori and Pacific women within Counties Manukau have low rates of breast reconstruction following mastectomy will ultimately help address inequities, according to one of the study’s authors.
The study was led by consultant surgeon Jenny Wagener and published earlier this year in the Australia New Zealand Journal of Surgery, found that of 26 women who had a cancer-related mastectomy during the study period of 2017, only one Maaori and no Pacific Island women went on to have breast reconstruction.
Study co-author and Counties Manuka Health (CM Health) plastic surgeon Michelle Locke says there are a number of factors contributing to this low uptake, including the fact that Maaori and Pacific women are less likely to meet the weight and smoking status eligibility criteria required for reconstructive surgery.
Having a high body mass index (a measure of weight in relation to height) and smoking are associated with poorer outcomes from surgery, Dr Locke explains.
“From a surgeon’s point of view, it’s technically more difficult to operate on a person with a BMI of over 30. The operation takes longer and there is a higher rate of complications,” she says.
Smoking compromises blood supply and also increases problems with the healing of wounds, Dr Locke says.
Women who don’t meet the criteria for reconstructive surgery are offered delayed reconstruction so they have time to engage with CM Health services to help them become healthier by giving up smoking and losing weight.
CM Health provides a free Living Smokefree Service which supports people to stop smoking and also funds Green Prescription (GRx) which is a support programme to help people to become more physically active and make better nutrition choices.
Breast reconstruction post mastectomy is associated with better quality of life for most women, so it is important that work is done to identify other barriers to Maaori and Pacific women accessing this service, Dr Locke says.
“We know there is inequity of access. We know that BMI and smoking are a problem from an eligibility point of view but there are a whole load of other cultural social and financial potential barriers and we haven’t fully explored what they all are.”
While it is disappointing to see such low rates of breast reconstruction among Maaori and Pacific women, defining the problem will help to deal with it, Dr Locke says.
“We can’t start addressing our inequity issue until we actually know what our inequity issue is, and so that’s why we do [the research].”
Dr Locke and the study’s lead Dr Jenny Wagener recently appeared on Maaori Television to discuss their findings.