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Do Government Policies Impact Breast Reconstruction Rates?

Every month, I look forward to receiving my copy of Plastic and Reconstructive Surgery, one of the main journals that publishes plastic surgery-related research papers. This month, a paper out of the University of Michigan caught my attention. The researchers looked at how federal and state policy changes affected breast reconstruction after mastectomy.

Breas reconstruction surgery ratesOne of the main policy changes considered is the Women’s Health and Cancer Rights Act of 1998. As we’ve described in previous blogs and on our resources page, this act, which is administered by the U.S. Departments of Labor and Health and Human Services, makes most insurance companies responsible for covering reconstruction after mastectomy. In addition to the initial reconstruction, it also includes coverage for all stages of reconstruction, including procedures that might be needed to achieve a symmetrical result.


The University of Michigan study showed that after the act was passed in 1998, women were more likely to undergo breast reconstruction after mastectomy. Their study, which looked at a database summarizing hospital admissions in the state of New York, showed that by 2006, women were over twice as likely to have breast reconstruction.


However, the study goes on to show that these increases are not equal for women of various ethnicities and races. For example, the increase of reconstruction for white women was 73 percent, which is much higher than the increases that were seen for Hispanic (38 percent) and African American (32 percent) women. These disparities suggest that more efforts are needed to communicate the reconstructive options that are available to women after mastectomy.


Fortunately, some states have passed legislation to promote exactly this type of activity. For example, in Ohio, the Lizzie B. Byrd Act (Ohio House Bill 147) requires a surgeon performing a mastectomy in a hospital to guide the patient and provide referrals in a manner consistent with the standards of the National Accreditation Program for Breast Centers. A recent proposal was made at the level of the federal government (S.1192 — 114th Congress) to pass a bill that would further promote education and awareness. Such legislation would likely have widespread impact on the rates of breast reconstruction.

About the Author

Ergun Kocak

Dr. Ergun Kocak, MD, MS, is a board-certified plastic surgeon who specializes in plastic and reconstructive surgery of the breast using DIEP, SIEA GAP, TUG, PAP, and direct-to-implant, in Columbus and Cincinnati, OH.
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