RT Book, Section
A1 Wolter, Keith G.
A1 Agarwal, Jayant
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145765721
T1 Implant-Based Breast Reconstruction
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK hemonc.mhmedical.com/content.aspx?aid=1145765721
RD 2024/04/20
AB Over  the  past  40  years,  breast  restoration  following  breast  removal  for  cancer  has  been  transformed  from  a  rarity  to  the  standard  of  care  in  major  U.S.  cancer  centers.  Concurrent  with  this  development  have  been  changes  in  extirpative  surgical  practices,  medical  and  radiologic  cancer  treatments,  and  financial  and  political  factors  impacting  the  management  of  breast  cancer.  Significant  among  the  latter  was  the  passage  of  the  Women's  Health  and  Cancer  Rights  Act  (WHCRA)  in  1998.  This  federal  law  was  inspired  by  the  case  of  a  woman  from  Long  Island,  New  York  who  was  denied  breast  reconstruction  coverage  by  her  insurer  on  the  grounds  that  the  company  considered  it  to  be  a  “cosmetic”  rather  than  “medically  necessary”  operation.  The  WHCRA  mandates  that  health  insurance  companies  and  group  health  plans  which  cover  mastectomies  must  also  provide  coverage  of  mastectomy-related  procedures,  including  breast  reconstruction  surgery,  prostheses,  and  procedures  to  restore  symmetry  in  the  contralateral  breast.1  The  practical  implication  of  this  law  is  that,  with  few  exceptions,  every  woman  who  now  undergoes  a  mastectomy  covered  by  her  insurer  also  has  coverage  for  subsequent  breast  reconstructive  procedures.  The  authors  feel  strongly  that  every  woman  who  undergoes  a  mastectomy  should  at  minimum  be  offered  a  consultation  with  a  reconstructive  surgeon  to  discuss  the  possibility  of  breast  reconstruction,  preferably  prior  to  any  breast  surgery  so  as  to  optimize  the  eventual  outcome.