Few Women Rebuild Breast After Mastectomy

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Rebuilding Breast

U-M expert: mandated insurance hasn't increased breast reconstruction following mastectomy and racial disparities still exist; other factors may be hindering practice

Fewer than 20 percent of American women eligible for breast reconstruction following mastectomy, or removal of the breast, for breast cancer undergo the procedure, according to experts at the University of Michigan Health System.

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In a letter published in the Jan. 25 issue of the Journal of the American Medical Association (JAMA), study lead author and U-M Health System Plastic Surgeon Amy K. Alderman, M.D., MPH, writes that despite mandated insurance coverage of breast reconstruction after mastectomy, disparities still exist in its use among certain races, including African Americans, Hispanics and Asians, and for women in certain regions of the country.

The findings, from a UMHS study of all women undergoing mastectomy for breast cancer from 1998 to 2002, assessed the impact of the Women's Health and Cancer Rights Act. The WHCRA was established in 1999 to mandate insurance coverage of breast reconstruction after mastectomy.

"We know that women who undergo breast reconstruction gain large improvements in their emotional, social and functional well-being, and hoped the law would increase use of reconstruction following mastectomy, since prior to the law, insurance companies did not cover the procedure," says Alderman, assistant professor in the Department of Surgery at the U-M Medical School and the Ann Arbor VA Health Care System.

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