In June 2012, the United States introduced bipartisan legislation aimed at increasing women's awareness about the reconstructive options available to them after a mastectomy.
Currently, under the Women's Health and Cancer Rights Act of 1998, insurance providers including Medicare and Medicaid that cover mastectomy as treatment for breast cancer are required by law to also cover all aspects of breast reconstruction. In the case of a unilateral mastectomy, this could include procedures on the contralateral breast to achieve symmetry. The number of women electing to undergo reconstructive surgery is, however, staggeringly low compared to the rates of women who have mastectomies. Currently, it is estimated that a mere 33% of eligible women actually undergo breast reconstruction.
The Breast Cancer Patient Education Act of 2012 intends to change that by informing women about their options and coverage for reconstructive procedures. According to key opinion leaders, the primary reason that women do not seek breast reconstruction is because they do not know that the option is available to them. Indeed, as one plastic surgeon stated, There's a huge amount of people that don't get counselled on this. I think that general surgeons do a great job of trying to do skin-sparing techniques but I don't think they're educating people about their reconstructive options.
The Act would require the Secretary of Health and Human Services to develop and implement an education campaign that informs women about all aspects of their rights to reconstructive surgery, including coverage and procedures available. The Act would presumably increase the rate at which breast cancer patients undergo reconstructive procedures, and, as a result, could bolster sales of breast implants, tissue expanders, and acellular dermal matrices. Most notably, the Act would increase women's overall knowledge about the reconstructive options available to them.
What is lacking from the Act, however, is any imperative to relay information related to the complications and risks associated with reconstruction using breast implants. Breast implants are not lifetime devices, and, the longer a woman has implants, the more likely it is that she will experience complications, often requiring revisionary surgeries. This is especially true of women who have breast implants after a mastectomy, with these patients exhibiting higher rates of complications compared to those undergoing breast augmentations for purely cosmetic reasons. Thus, while plastic surgeons are extolling the Act, I believe that to be a truly inclusive piece of legislation, the Act (and its subsequent education campaign) should present a balanced view to women about not only the options available, but also any associated risks. The more knowledge a woman has, the more capable she will be to make a truly informed and empowered decision regarding her recovery from breast cancer whether she chooses to have her breasts reconstructed or not.