Although Botox is the most popular aesthetic procedure for women over age 35, this hasn’t always been the case within the Hispanic community. However, a 2009 report showed that the number of Hispanic clients who received Botox procedures increased by 18% nationwide from a year prior. In addition, 10% of all 12 million cosmetic procedures performed throughout the U.S. in 2008 were on Hispanic clients.

But this trend hasn’t necessarily extended to plastic surgery. Three different national databases have now reported that Latina, African American, and Asian women are less likely than white women to opt for immediate breast reconstruction after undergoing removal as part of breast cancer treatment.

Approximately 39.6% of both women and men will be diagnosed with cancer at some point in their lives. When researchers analyzed data from 2005 to 2012 involving 1.2 million breast cancer patients, they found that overall rates for immediate breast reconstruction (or IBR) had gone up. The information from the three different databases — the Agency for Healthcare Research and Quality’s Nationwide Inpatient Sample (NIS), the American College for Surgeons’ National Surgical Quality Improvement Project (NSQIP), and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program — differed quite a bit, but all three showed similar tendencies.

Each database showed that white women were the most likely to get immediate reconstructive surgery. However, their rates varied significantly. NIS showed that 35.7% of white women with invasive breast cancer opted for reconstruction, while 30.8% of Hispanic women, 30.5% of Asian women, and 27.3% of black women did so. NSQIP reported similar percentages, with 43.1% of white women, 40.3% of Hispanic women, 32.1% of Asian women, and 30.7% of black women opting for IBR.

The rates from SEER were quite a bit lower and stood in contrast to the other two databases, showing that Hispanic women were the least likely to get IBR: 20.6% of white women, 12.9% of Hispanic women, 14.0% of Asian women, and 15.5% of African-American women had immediate breast reconstruction. However, this discrepancy could be attributed to the fact that SEER covers no major U.S. cancer centers and covers less than half of the country, while the NIS and NSQIP records pertain to the majority of the nation.

But there could also be other factors at play, like healthcare coverage and other components. And because these kinds of databases can actually inform changes to medical insurance policies, researchers stress that lawmakers need to pay attention.

“Since these large databases play an important role in making healthcare policy, it’s important to appreciate the significant differences in racial and socioeconomic disparities in immediate breast reconstruction,” said study author and member of the American Society of Plastic Surgeons, Samuel J. Lin, MD, MBA, of Harvard Medical School, in a press release. “One database should not uniformly be utilized for clinical guidelines and policies.”