Advocacy for Breast Reconstruction Patients
What We Are Working On
Protecting access to modern breast reconstruction through insurance for all people facing surgery to treat or prevent breast cancer.
Breast reconstruction using a woman’s own tissue should be an option for all woman facing breast reconstruction; however, access to the best and most modern natural reconstruction procedure, DIEP flap reconstruction, is being threatened due to insurance companies refusing to pay for the procedure women need and deserve.
Where To Send You Letter CONTACTS
For House and Senate, please copy and paste your letter of support into your contact request to each representative:
Additional Contacts
For Microsurgery Colleagues and Physicians:
- American Society for Reconstructive Microsurgery (ASRM):
- American Society of Plastic Surgeons (ASPS):
Supporting Efforts to Preserve Access To Natural Breast Reconstruction
Background
Breast reconstruction may be performed with an implant or with a woman’s own tissue. The decision is highly personal and individualized. Each patient should discuss the full range of options with their care team and have the chance to choose what is best for them. For example, patients may choose aesthetic flat closure, implant placement, or reconstruction with tissue from another part of their own body.
Natural tissue reconstruction using tissue from a patient’s own body is less commonly performed than implant reconstruction in the United States, but it is increasing as women are informed about their options. Some women choose to use their own tissue because they want a life-long reconstruction instead of an implant, which is not a lifetime device. Some women choose to use their own tissue because they prefer a natural reconstruction over a foreign body or medical device. Some women choose to use their own tissue because they have undergone radiation and understand the increased health risks of having implants in the setting of radiation, such as capsular contracture, infection, asymmetry, and reconstruction failure.
Details
All surgeries are not equal. When natural tissue reconstructions were first developed, surgical techniques were not refined, and the side effects of the surgery were severe. Importantly, early efforts to reconstruct a breast caused harm and injury to a woman’s muscles. In some cases, as in fTRAM reconstruction, an entire abdominal muscle was removed, leaving the woman with lifelong weakness and hernia. As surgeons gained knowledge and experience, they developed techniques that don’t remove muscle. The new surgery, called a DIEP reconstruction, is more difficult to perform, but the benefits to the patient are profound. A woman can have a breast reconstruction with a DIEP flap and still lead an active and productive life, without the lifelong weakness and side effects caused by removing her rectus abdominis muscle.
Challenges
CMS has announced that they are equating all breast flaps (like DIEP and fTRAM) and insurance companies have begun to stop paying for the more advanced DIEP procedure that women need and deserve.
We are advocating for you! If you want to get involved in these efforts, please contact us directly.
Resources for Access Changes To Breast Reconstruction
Please join the non-profit organization CBRA in the fight to preserve patient access to all forms of breast reconstruction:
You can also explore the links below to help understand the complexity of issues following new limitations to breast reconstruction access, including the DIEP free flap:
