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New York Law Requires Breast Cancer Patients to be Informed of Reconstruction Coverage

SGK Plastic Surgery Blog

Woman holding her chestA new law in the state of New York requires hospitals in the state to inform breast cancer patients the availability of and insurance coverage for breast reconstruction before they undergo “mastectomy surgery, lymph node dissection or a lumpectomy.”

Breast reconstruction after a mastectomy is covered by insurers in New York, but often poor and minority women do not seek out the procedure because they may be unaware of coverage. Congress passed the Women’s Health and Cancer Rights Act in 1998, which guaranteed universal coverage for breast reconstruction after cancer surgery.

“A disproportionate number of women who are at a socioeconomic disadvantage do not get breast reconstruction surgery after a mastectomy for one of several reasons. Either they are unaware of it as an option, they do not know it is covered by Medicaid and Medicare insurance programs, they do not know where to gain access to the procedures, or it is never mentioned to them by their other doctors,” said Dr. Evan Garfein, the plastic and reconstructive surgeon who authored the bill.

There are several reconstruction options for cancer patients, including saline and silicone gel implants, as well as reconstruction that uses the patient’s own tissues from the abdomen, thigh, back or buttocks.

“Breast reconstruction has been repeatedly shown to improve the quality of life and overall well-being of women who have been treated for breast cancer,” said Dr. Garfein. “This new law will ensure that breast cancer patients from all socioeconomic groups are informed about their options regarding breast reconstruction and about where to get the procedure.”

The discussion should involve both the cancer surgeon and the plastic surgeon, so the surgical team and the patient can then decide if reconstruction should be performed and in what timeframe.

Dr. Kim is double-board certified by the American Board of Plastic Surgery and by the American Board of Surgery and performs breast reconstruction in the Houston, Texas area.

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