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You are constantly learning when it comes to breast cancer. That’s true of breast reconstruction and restoration as well. The more you know, the more informed your decisions can be.
Here is some helpful information about your legal medical rights and your reconstructive options. While there are numerous sources of information available to you, we’ve compiled information from sources we trust.
We will respect and support you, whatever your choice.
Options
You may choose immediate, delayed, or no reconstruction at all. Before you decide, understand all your options.
“Going Flat”:
While most women choose to have some type of breast reconstruction after mastectomy, a number of women decide to have no reconstruction.
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According to research discussed on BreastCancer.org, nearly 75% of women surveyed who opted for mastectomy without reconstruction were satisfied with the results, but almost 25% said their decision to go flat was not supported by their surgeons.
Lumpectomy:
Learn more about lumpectomy, also called breast-conserving surgery, here. It is a procedure that removes the breast cancer along with a small amount of the healthy tissue surrounding it.
Mastectomy:
There are several different types of mastectomy. You and your doctors will work together to decide which is best for your individual situation. Visit BreastCancer.org for more detailed information.
Breast reconstruction:
The American Cancer Society describes two main types of breast reconstruction:
- Implant reconstruction
- Tissue (flap reconstruction)
You and your doctors will need to discuss many factors before landing on the option that works best for you. Some considerations include:
- Your medical history and overall health
- Your breast size
- The size and location of your cancer
- The extent of your breast cancer surgery
- Your preference for reconstructed size and symmetry
- Insurance coverage and related costs
The Breast Reconstruction Surgery section is full of credible information. Get started by reviewing their “Questions to Ask Your Surgeon About Breast Reconstruction.”
The Aesthetic Society has great information about reconstructive mammaplasty or postmastectomy surgery here.
Review the sites below to learn more about tissue expanders and implant resources.
Legal Rights
Health insurance can be confusing. It is best for you to contact your insurance provider to ensure you have a clear understanding of your medical coverage.
If you have had a mastectomy or expect to have one, you may be entitled to special rights under the Women’s Health and Cancer Rights Act of 1998 (WHCRA).
WHCRA is a federal law that provides protections to patients who choose to have breast reconstruction in connection with a mastectomy. If WHCRA applies to you and you are receiving benefits in connection with a mastectomy and you elect breast reconstruction, coverage must be provided for:
- All stages of reconstruction of the breast on which the mastectomy has been performed;
- Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
- Prostheses and treatment of physical complications of all stages of the mastectomy, including lymphedema.
Group health plans (provided by an employer or union): WHCRA requires group health plans and health insurance companies (including HMOs), to notify individuals regarding coverage required under the law. Contact your employer’s plan administrator to find out if your group coverage is insured or self-funded, to determine what entity or entities regulate your benefits.
Individual health insurance policies (not based on employment): Health insurance sold to individuals (not through employment) is primarily regulated by State insurance departments. Contact your State’s insurance department to find out whether additional State law protections apply to your coverage if you are in an insured group health plan or have individual (non-employment based) health insurance coverage.
WHCRA does NOT require group health plans or health insurance issuers to cover mastectomies in general. If a group health plan or health insurance issuer chooses to cover mastectomies, then the plan or issuer is generally subject to WHCRA requirements.
For more information on WHCRA, click here or check out the Employee Benefits Security Administrations brochure titled “Your Rights After A Mastectomy.”