For 35-year-old Laura Scott, finding a lump in her breast last year was shocking. She has no family history of breast cancer- and had always been healthy and active.

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Further testing revealed the mother of two had stage one invasive breast cancer. She had chemotherapy, a double mastectomy and then breast reconstruction.

“As a woman, your breasts don't define you, but they're a part of you and for me not having them was just unthinkable,” she says.

But a just-released study finds only one-third of breast cancer patients have breast reconstruction after mastectomies. Patients under age 50 and being treated at teaching hospitals are more likely to have reconstruction.

And the women with insurance are three-times more likely to opt for the surgery.

Georgetown University Hospital breast surgeon Shawna Willey says about 85 percent of her patients have breast reconstruction. But some simply don't want any unnecessary surgeries - even when it’s been shown to improve self-esteem and body image.

“It's one aspect of a woman's care around her breast cancer that she can control,” Willey says.

Scott says she made the right choice having breast reconstruction but believes every woman has to make that decision for herself.