Barriers of Access to Breast Reconstruction

A Systematic Review

Helene Retrouvey, M.D.C.M.; Ogi Solaja, M.D.; Anna R. Gagliardi, Ph.D.; Fiona Webster, Ph.D.; Toni Zhong, M.D., M.H.S.


Plast Reconstr Surg. 2019;143(3):465e-476e. 

In This Article


This systematic review is the first to categorize barriers to breast reconstruction access according to Penchansky and Thomas's six domains of access to care. Barriers were found to be multifactorial and influenced by an institution's ability to accommodate the patient's needs, the physician's attitude toward breast reconstruction, and the patient's ability to access and afford the service. To target these barriers and improve access, multiprong interventions are needed. These could include streamlining of breast cancer care to facilitate the discussion and referral process for breast reconstruction, improved awareness of the option of breast reconstruction, and refining physician knowledge of the indications for breast reconstruction. Future research is needed to design and evaluate interventions aimed at targeting the identified barriers.