Breast Reconstruction

The American Cancer Society estimates that 178,480 women will be diagnosed with invasive breast cancer this year. Although many will be able to have breast conserving surgery, i.e., lumpectomy, many will need or prefer a mastectomy, or complete removal of the breast.
Some women need this procedure, because the cancer cannot be completely removed with a lumpectomy. Others prefer it, fearing a recurrence or hoping to avoid the weeks of radiation often required after a lumpectomy.
Additionally, hundreds of other women at very high risk of breast cancer will undergo a prophylactic mastectomy, or removal of their breasts to prevent breast cancer.
To many women, the loss of a breast is a devastating occurrence, one that strikes at their very sense of self. They may feel less feminine without a breast, find it awkward to have a missing breast or breasts under clothes, and find using a prosthesis, or rubber breast form, difficult. Thus, many women choose to undergo breast reconstructive surgery after mastectomy.
In 2006, about 56,176 women underwent some form of breast reconstruction, according to the American Society of Plastic Surgeons (ASPS). That represents a 31 percent decrease since 2000, likely due to the greater number of breast-conserving surgeries being performed today.
Overall, however, studies find that breast reconstructive surgery is underutilized. A recent report published in the Journal of the American Medical Association showed that of the 51,184 women identified who underwent a mastectomy between 1998 and 2002, only 16.5 percent had breast reconstructive surgery.
This study also found that the decision to have breast reconstructive surgery is significantly affected by where you live, your race, age and stage of cancer. Specifically, the researchers found, African-American, Hispanic and Asian women were significantly less likely to have immediate or slightly delayed breast reconstructive surgery than white women.
If you choose to have breast reconstructive surgery, you have two main options: breast implants, using silicone shells filled with silicone gel or saline, or autologous reconstruction, which uses fat and tissue from your abdomen, back, buttocks or thigh to shape a new breast. In many instances, breast reconstructive surgery can be performed immediately after mastectomy so you never wake up without a breast.
If you have health insurance, your carrier must pay for breast reconstructive surgery. The 1998 Federal Breast Reconstruction Law requires all health insurance companies to cover reconstruction of the breast on which mastectomy has been performed, and surgery and reconstruction of the other breast to produce a symmetrical appearance.
If you don't have health insurance, talk to your surgeon and the hospital about negotiating a discount rate. Many are willing to do that for women without insurance. You may also qualify for health insurance under your state's Medicaid program or other health-coverage programs for low- and moderate-income individuals.