In December, Congress passed the Breast Cancer Patient Education Act (BCPEA). The American Society of Plastic Surgeons (ASPS) proudly led the stakeholder effort to advance this bipartisan policy, first introduced in 2012, and worked closely with its champions in Congress to shepherd it through the legislative process. The BCPEA aims to inform breast cancer patients of the availability and coverage of breast reconstruction, prostheses, and other options. “This is a proud day,” says president David Song, M.D. “ASPS has engaged in years of grassroots and direct advocacy in support of this bill, and so this is a victory for our organization and for the specialty of plastic surgery. Most importantly, though, it is a victory for our patients who have survived breast cancer. Every woman has a legal right to reconstructive services if their insurer covers breast cancer treatment, and ASPS has always believed that they also have a right to be informed about their reconstructive options. In that vein, ASPS has long been troubled by—and worked to fill—gaps in access to reconstructive services resulting from gaps in patient knowledge. This law is a major step toward the goal of universal patient awareness of their reconstructive rights.”
Since passage of the Women’s Health Care and Cancer Rights Act in 1998, health plans that offer breast cancer coverage have been required to provide coverage for breast reconstruction and prostheses. However, less than half of all women requiring a mastectomy are currently offered breast reconstruction surgery and fewer than one in five elect to undergo the procedure. While there is little consensus as to why women do not choose to undergo the procedure following their mastectomy, a recent study in The Journal of the American Medical Association confirmed that almost one-fifth of women who do not undergo breast reconstruction reported a lack of knowledge regarding the procedure.
The BCPEA addresses this problem by requiring the Secretary of Health and Human Services to plan and implement an education campaign. The educational materials would inform women that breast reconstruction is possible at the time of breast cancer surgery, that it may be delayed until after other treatments, or that they may choose not to have reconstruction and instead opt for prostheses or breast forms. According to Song, the BCPEA is ultimately about “getting the best information in the hands of women and their families to empower them in making the best choice for their care. In recent years, we have gained a deeper appreciation for the fact that cancer treatment leaves not just physical scars, but also psychological, spiritual and emotional scars. Reconstruction can play a role in treating those non-physical forms of pain, and all members of the cancer team have an obligation to, at a minimum, make sure that their patients understand their treatment options. Anything less is unacceptable. That is why ASPS worked so hard to pass this legislation and why we are so happy to see it become law.”