The study, published in the October issue of Plastic and Reconstructive Surgery, surveyed 250 breast cancer patients at 12 medical centers in the United States and Canada. Researchers say it adds to the scientific evidence in favor of reconstruction and contradicts past findings that a particular approach to the surgery is significantly better.

"Women need to take a close look at the options and decide what?s best for them," says Edwin Wilkins, MD, associate professor of surgery at the University of Michigan and lead researcher in the Michigan Breast Reconstruction Outcome Study (MBROS). "This research indicates that, whichever way they decide to go, the chances are good they?ll do well."

During the past decade, reconstruction has become an increasingly popular option for women facing the loss of a breast. It can be done at the time of a mastectomy (immediate reconstruction) or months or years later (delayed reconstruction). The breast can be formed using a tissue expander and an implant filled with saline or silicone. Another technique, called TRAM reconstruction, uses the patient?s own tissue. A surgeon takes muscle, blood vessels, fat and skin from the stomach or another part of the body and moves it to the chest.

In this study, 194 women had some type of TRAM procedure and 56 received implants. Two-thirds of the women had reconstruction during mastectomy surgery. The women completed questionnaires just before reconstruction and a year later. The surveys evaluated issues such as emotional well-being, vitality, general mental health, social functioning and body image.

"For women undergoing mastectomy, what may matter most is whether they receive immediate reconstruction," Wilkins says. "The largest effect seemed to occur in those who came out of mastectomy surgery with a new breast in place, but even patients who waited experienced a substantial positive upswing."

Among women who had immediate reconstruction, the choice of implants or TRAM procedure had no effect on their overall increase in well-being. For women choosing delayed reconstruction, the procedure choice did seem to matter in a couple of the measured outcomes. Those who had implants showed greater gains in vitality and social well-being, which may reflect that TRAM procedures require more extensive surgery and a longer recovery period. Those who had TRAM procedures noticed greater improvements in body image. Wilkins says this may be due to the more natural feel of a TRAM breast.

Wilkins says any differences between immediate and delayed groups shouldn?t overshadow the finding that everyone seems to benefit. "This affirms Congress?s decision two years ago to require insurance companies to cover reconstruction," he says.

"This study does support the needs of women to have breast reconstruction as an option given to them," says Terri Ades, RN, MS, an advanced oncology nurse and director of health content for the American Cancer Society. "But there are important factors that could affect the results of the study. For example, how did the physicians present breast reconstruction to women? Were the women given choices? Did they understand the choices? These can easily influence the study."

Wilkins says the MBROS is now analyzing data on these same women two years after reconstruction. The researchers are looking at long-term psychological effects and at the benefits of reconstruction compared to the costs.