Purpose:  There is concern that minority women may have limited access to post-mastectomy breast reconstruction despite federally mandated coverage by the Women’s Health and Cancer Rights Act.  Our purpose was to describe the use of breast reconstruction among Latinas and investigate barriers to reconstructive services.

Methods: A sample of women age ≤79 years who were diagnosed with ductal carcinoma in situ and invasive breast carcinoma between 2005 and 2006 was identified from the Surveillance, Epidemiology and End Results (SEER) registry in Los Angeles.  Eligible subjects completed a questionnaire at a mean 7.7 months after diagnosis (response rate 71.4%).  Chi-square test was used for data analysis.

Results:  Of the 1449 respondents, 500 (34.5%) underwent a mastectomy.  Receipt of breast reconstruction varied significantly by patient race/ethnicity: 35.9% non-Latina whites, 28.4% blacks, 35.7% English-speaking Latinas, and only 13.2% of Spanish-speaking Latinas received reconstruction (p < 0.001).  Compared to the other racial/ethnic groups, Spanish-speaking Latinas were least likely to plan on getting reconstruction in the future (p= 0.009) and were most likely to face significant barriers to reconstructive services.  Comparing Spanish-speaking Latinas to non-Latina whites, 15.2% vs. 1.3% didn’t know how to get breast reconstruction (p <0.001), and 13.3% vs. 1.3% didn’t get reconstruction due to financial barriers (p <0.001). Conclusions:  Breast reconstruction appears to be under-used in the Spanish-speaking Latina population, as these women face knowledge and financial barriers to surgery.  Further work is needed to better educate minority women about their reconstructive options for breast cancer and lessen the financial burden these women face to reconstructive surgery.

Table 1: Receipt of immediate breast reconstruction among breast cancer patients treated with a mastectomy between 2005 and 2006 in the Los Angeles SEER Registry
	Non-Latina Whites	Blacks	English- Speaking Latinas	Spanish-Speaking Latinas
	(N=145)	(N=130)	(N=100)	(N=125)
	%	%	%	%
Received immediate breast reconstruction*	35.9	28.4	35.7	13.2
Planning on reconstruction in the future	34.7	25.0	30.2	23.8
No future plans for reconstruction	29.4	46.6	34.1	63.0
* Pearson chi-square, p < 0.001