Las Vegas Plastic Surgery
New York Gov. David Paterson signed a new law that requires hospitals and doctors to discuss the available options and insurance coverage for breast reconstruction before patients undergo “mastectomy surgery, lymph node dissection, or a lumpectomy.”
The New York Times credits Evan Garfein, MD, Bronx, N.Y., as a driving force behind getting the law passed.
Dr. Garfein, who specializes in reconstructive surgery, noted that only 30 to 40 percent of all women who had mastectomies receive breast reconstruction. He began to push for the new law after learning of research that showed low income and minority women were much less likely to receive breast reconstruction after cancer than more affluent women.
“Most reconstructive surgeons are aware of the studies that have been done by Amy Alderman, MD, on the disparities in the rates of breast reconstruction based on socioeconomic and some geographic determinants.”
The bill passed unanimously.
Dr. Garfein notes that a key to the success of the bill was the funding that already existed through the Women’s Health and Cancer Rights Act of 1998. This mandated insurance companies to cover reconstructive breast surgery. However, disparities in access still remain.
“Breast reconstruction has been repeatedly shown to improve the quality of life and overall well-being of women who have been treated for breast cancer,” said Dr. Garfein. “This new law will ensure that breast cancer patients from all socioeconomic groups are informed about their options regarding breast reconstruction and about where to get the procedure.”
This early discussion of treatment options will enable a better coordinated, team approach between oncologist, breast surgeon, and plastic/reconstructive surgeon. This should lead to better outcomes for the patient.
Jeffrey J. Roth, M.D., F.A.C.S.
Do Variations in Provider Discussions Explain Socioeconomic Disparities in Post-Mastectomy Breast Reconstruction? Greenberg CC, Schneider EC, Lipsitz SR, Ko CY, Malin JL, Epstein AM, Weeks JC, Kahn KL. J Am Coll Surg. 2008 Apr;206(4):605-15.
Racial and Ethnic Disparities in the Use of Post-Mastectomy Breast Reconstruction: Results From a Population-Based Study. Alderman AK, Hawley ST, Janz NK, Mujahid MS, Morrow M, Hamilton AS, Graff JJ, Katz SJ. J Clin Oncol. 2009 Nov 10;27(32):5325-30.