In 1998, then President Bill Clinton breast reconstruction after mastectomy signed into the law the Women’s Health and Cancer Reconstruction Act (WHCRA). The intention of this bill ended up being to ensure than patients who underwent mastectomy for the treating of cancer of the breast could get access to reconstruction through their insurance plans.
Many insurances did not cover reconstruction after breast cancer surgery because it was considered ‘cosmetic’ surgery previously. Many patients thought this as well, and as a result, avoided undergoing reconstruction. As of 2012 the National Cancer Institute reports that only about 20% of breast cancer patients receive reconstruction, even though the law was supposed to rectify that situation.
Why is that? The causes are complex, and involve a mix of things.
When a patient is clinically determined to have cancer of the breast, it is usually stressful and emotional, as anyone might expect, and often the foremost problem is getting rid of the cancer-not the way that they will appear afterwards, which I understand. Therapy for cancer dominates the practical strategy to cancer, and rightly so. Without having a cure, there is absolutely no reconstruction.
Reconstruction is generally regarded as a ‘secondary’ procedure and not part of the ‘primary’ aim of treatment, which is, of course, curing the cancer, as a result. So, even in spite of a government mandate that provides insurance coverage for the process of breast reconstruction, this is apparently not enough to influence the practical approach both doctors and patients.
However I argue, having performed many breast reconstructions, that area of the cure also entails creating a patient feel whole again, and for many women (while not all) this entails reconstruction, or at a minimum the ability to pursue it, if you have desired.
A 20% reconstruction rate suggests that breast reconstruction after cancer surgery is not always given the place it really deserves in the treatment of cancer because it is still consideredoptional and secondary, or not that critical to consider initially.
But to be fair, there are also other considerations as well, which are important, the most important being is that often breast cancer reconstruction involves as heavy commitment of time, and often multiple surgeries to achieve its results. This is not all that attractive to somebody who has been through the stress and worry of cancer surgery accompanied by a course of chemotherapy and radiation, which is understandable. All things considered, who would like to proceed through a period consuming and stressful process immediately after they may have experienced a period consuming and stressful process?
And lastly, there is certainly, whether people prefer to admit or otherwise not, a sense that breast reconstruction is sort of a ‘vain’ undertaking. Beating cancer takes courage, and part of courage is humility and thankfulness, which seem at odd with wanting to make yourself look better.
It is a real phenomena which I have observed personally in my practice, though i don’t agree with this perception. Consider this for just a moment. Imagine you are a young woman, and maybe you have children, and you will have just fought and survived through cancer of the breast. In order to make yourself look and feel better may not be as important to you as spending time with your loved ones, your perspective on what is really important may change as a result of the experience you just had, and now, the investment of time and effort that is necessary to have a reconstructed breast. If you are an older woman, you may think something along the lines of, likewise: what might I want a breast later in my life?
But undergoing reconstruction from the breast after cancer surgery is not really a vain or self-centered pursuit by any means. Once again, beating cancer takes great courage, and thankfulness, indeed and humility are integral parts of courage, but so are feeling confident, whole, and strong, which breast cancer reconstruction can help provide for many patients.
With that being said, ultimately what exactly is most significant is really a patient’s wishes, you will find, sometimes delaying or forgoing cancer of the breast reconstruction altogether is the best step that may be taken for a few of the reasons i have mentioned before (ie stress, family, time commitment, etc.)
Still, and it suggests something breast reconstruction after mastectomy more to me than people don’t want breast cancer reconstruction because they are too tired after cancer treatment or think that the process is somewhat vain, a 20% rate of breast reconstruction is awfully low. If you have no intention of every undergoing breast reconstruction, you should talk the time to inform and educate yourself about the option in detail through a consultation with a board certified plastic surgeon, it suggests a lack of information, and it is an important reason why I believe that even.