Did you know that group health plans, insurance companies, and HMOs that offer mastectomy coverage must also provide coverage for reconstructive surgery after a mastectomy? Did you know that government insurance is also required to do so? If you didn’t, you’re not alone: A recent study found that more than half of uninsured women are not properly informed about their options after a mastectomy—and that this lack of education means that fewer uninsured women opt for breast reconstruction than would otherwise. Patients—whether or not they have insurance—should be told about their reconstructive surgery possibilities as soon as they’re diagnosed with breast cancer. But according to this study’s co-author, Dr. Jamie Levine, many uninsured patients are never having that conversation with their doctor, and are therefore unaware that breast reconstruction is even an option for them. He and his colleagues found that when steps were taken to educate uninsured patients about the choices available to them, 76% of women chose reconstruction (a 29% increase from the 47% who chose it otherwise).
Clearly the responsibility here falls on health practitioners: Doctors should ensure that their patients are given adequate information about all of their treatment options, and ideally they should also refer their breast cancer patients to a plastic surgeon for a consultation before their mastectomy so they truly understand what reconstructive surgery entails. Many plastic surgeons, including myself, also offer free consultations with or without a referral. Breast reconstruction may not be for every woman—but every woman, insured and uninsured, has the right to know that it’s an option.