The WHCRA (Women’s Health and Cancer Reconstruction Act) was signed into law in 1998 by then-President Bill Clinton. The goal of the bill was to make sure that if a women had to have a mastectomy due to breast cancer, she would be able to access breast reconstruction through her insurance as well. Indeed, before the WHCRA, many insurance companies did not cover these procedures, classing them as “elective cosmetic”. Yet, despite this law now being in force for almost 20 years, the National Cancer Institute has reported that, as of 2012, still only 20% of mastectomy patients have reconstructive surgery.
Why Some Women Do Not Have Breast Reconstruction
There are numerous and very complex reasons why women do not access breast reconstruction services. One of the first reasons is that women are too busy battling cancer. Survival, at that moment, is far more important than reconstruction. As a result, it is seen as something “secondary”, rather than a full part of the overall treatment plan. Hence, although the law states it should be part of the process, the reality is that, practically, it continues to be almost elective.
Thankfully, more and more physicians now understand that part of the recovery should be for the woman to feel whole again. And, for many, this means having breast reconstruction surgery. The fact that only 20% of women access this means, however, that not enough emphasis is placed on it.
Of course, there are other considerations to make as well, including:
- The fact that reconstruction will often require multiple surgeries, and women don’t want to go through that after already going through breast cancer.
- The fact that there is an element of vanity associated with it, when surviving breast cancer is about being humble and thankful, not looking better.
- The fact that many women with breast cancer are somewhat older, and they often feel they no longer “need” their breasts.
The latter is something few physicians will sign up to. However, it seems that, on a psychological level at least, many women feel that it is true. They feel that they have gone through a huge battle to survive cancer, and physical appearances simply aren’t as important anymore as what they used to be. Physicians, however, feel that recovering from cancer is about more than thankfulness, humility, and courage. It is also about feeling strong, whole, and confident, and this may mean having new breasts.
Ultimately, it should be down to what the patient wants. Sometimes, not having surgery, or delaying surgery, is the best option out there. However, never should a woman who has survived breast cancer be made to feel like she shouldn’t have surgery because it makes her vein. The procedure is there to complete and finalize the healing process, when a woman is ready for it herself. Embracing a new body is fine, but it is equally find to want to return to the previous body, or even to have somewhat of an improvement.