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July 2018

Addressing Continued Disparities in Access to Breast Reconstruction on the 20th Anniversary of the Women’s Health and Cancer Rights Act

Author Affiliations
  • 1Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor
  • 2The Swan Center for Plastic Surgery, Alpharetta, Georgia
JAMA Surg. 2018;153(7):603-604. doi:10.1001/jamasurg.2018.0387

Approximately 12% of women in the United States will develop invasive breast cancer during their lifetime. Despite the growing use of breast conservation as primary therapy for breast cancer, mastectomy remains a common treatment option. Furthermore, as our understanding of genetic risk for breast cancer has improved, prophylactic mastectomy is increasingly performed to prevent this malignancy in women who belong to certain high-risk groups.1 For patients undergoing mastectomy, the repercussions for body image, psychosocial well-being, and quality of life can be distressing.2 Years of research documenting the health-related quality of life and psychosocial benefits of breast reconstruction after mastectomy empowered health advocacy groups to lobby for the Women’s Health and Cancer Rights Act (WHCRA). Enacted in 1998, the WHCRA mandates all-payer health insurance coverage of all stages of breast reconstruction, including procedures on the contralateral breast for symmetry.

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