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January 25, 2006

Use of Breast Reconstruction After Mastectomy Following the Women's Health and Cancer Rights Act

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295(4):383-388. doi:10.1001/jama.295.4.387

To the Editor: Despite the quality-of-life benefits of breast reconstruction for women who have undergone mastectomy for breast cancer,1 less than 20% of eligible patients have this procedure done.2 Considerably lower reconstruction rates occur in many geographic regions and in some racial and ethnic groups.2 Low utilization has been attributed to nonuniform coverage of breast reconstruction by insurers who viewed the procedure as primarily cosmetic.3 For this reason, the Women's Health and Cancer Rights Act (WHCRA), which mandated insurance coverage of breast reconstruction after mastectomy, was implemented in 1999,4 followed in 2001 by additional legislation imposing penalties on noncompliant insurers.5 We assessed the impact of the WHCRA on practice patterns related to breast reconstruction.