I was interviewed this fall by a breast cancer survivor and an author about options for breast cancer reconstruction.  This woman lives in Florida and was astounded when she learned in her chemotherapy group that other women were not offered breast reconstruction at all by their treatment team, or were told insurance would not cover it.

“Why would this be?”, she asked me.  “Is it true that only some women who live near a university teaching hospital can have reconstruction after mastectomy?”.

Why is a whole month dedicated to breast cancer awareness?

She asked me the following questions about breast reconstruction:

• Which women are candidates for breast reconstruction?
• Do they need to complete their chemotherapy and/or radiation treatments first?
• Does everyone need an implant?
• Will my breast ever recover sensation?  Can I breast feed still?
• Does insurance cover this surgery or is it considered cosmetic?
• Why didn’t the Plastic Surgeon I see discuss some options I’m interested in – such as the DIEP flap or TUG flap, saving my nipples or single-stage surgery?
• What if I don’t need a mastectomy – just the lump removed?  Can I still have reconstruction?
• How do I know which reconstruction is best for me?

Click on the article below to see the entire breast cancer awareness publication, and forward to page S6 to read the article about tailoring the treatment (including breast reconstruction) to the patient:

Click to Open and Download

It is unfortunate that not all women who are facing breast cancer, or who have a copy of the BRCA gene and are seeking prophylactic (risk-reducing) surgery, are offered the latest and greatest options for breast reconstruction.

It is a LEGAL RIGHT, but also morally imperative that Plastic Surgeons, Breast Surgeons, Medical Oncologists, Radiation Oncologists, Nurse Navigators, Genetic Counselors and any other health care provider help to educate women about which options are available to them.

Breast reconstruction is NOT considered cosmetic, and as long as a woman has health insurance, her reconstruction and a balancing procedure on the other breast (a lift, reduction, augmentation or revision of previous surgery) is also considered part of the reconstruction.  As long as the Plastic Surgeon is a provider for her insurance plan, a woman should be able to see that surgeon and have her medical insurance cover the procedure within the agreement of copayments.

I wonder if it is ego that causes some surgeons who do not perform the procedure of interest to the patient (for example, the DIEP flap) to dissuade the patient from going that route, and instead have a different (and less desirable) procedure, such as the TRAM flap – which permanently sacrifices a major core muscle of the body and the irreplaceable fascia overtop.

When I see a patient who requests a procedure I do not regularly perform (such as a complicated rhinoplasty), I always examine them, provide them with the full “menu of options” but then refer that patient to the best practitioner for the job.  For the sake of women facing breast cancer, I hope that my colleagues do the same.

I encourage women to DO THEIR HOMEWORK when it comes to planning surgery.  Thankfully, the internet is a good place to start, and word of mouth such as at cancer support groups and recommendations from other breast cancer survivors.

“Yay, BOOBIES!” was our mantra for BRA Day 2014!

To learn more about breast reconstruction options to women in the Bay Area, visit my educational website, download my printable PDF about breast reconstruction or complete our online consultation request form today!