Breast reconstruction is a procedure to rebuild a breast after a mastectomy or lumpectomy to treat breast cancer or other breast lesions. Surgical procedures aim to restore the shape and size of a woman’s breast that has been removed due to cancer treatment or to mitigate the risk of cancer in patients with a genetic predisposition, such as those who carry the BRCA gene. The procedure can be performed using various techniques, including implant-based reconstruction and autologous tissue reconstruction, which uses the patient’s own tissue to reconstruct the breast. The choice of technique depends on various factors, including the patient’s preference, body type, and the extent of breast tissue removed during cancer treatment, and any additional treatments such as radiation.
Breast reconstruction typically involves multiple stages and may include additional procedures to create symmetry with the unaffected breast. Breast reconstruction after mastectomy is considered a necessary part of treatment for breast cancer if the patient desires reconstruction.
The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires most health insurance plans that cover mastectomy to also cover breast reconstruction surgery. This applies to any type of health plan, including group plans, individual health plans, and employer-sponsored plans. Additionally, the WHCRA mandates coverage for any additional procedures that may be required to achieve symmetry between the reconstructed breast and the opposite breast. However, there may be some limitations and requirements for coverage. Check with your insurance provider for specific details.