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Surgeon predicts higher breast cancer survival rates (5/29/97)

Elizabeth sat before her family physician trying to recover =66rom shock. Her doctor had just told her she had cancer and must have an immediate mastectomy. Her head was reeling and her breath came in short gasps, and when the physician began explaining what the surgery entailed, Elizabeth heard only a few words--lymph nodes and physical therapy and chemo. When her mind finally began to register, the doctor was telling her about hair loss. Elizabeth was appalled! Not only would she lose her breast and be scarred for life, she was also going to lose her hair! She imagined her future--she would be disfigured and bald. She wondered how her husband could continue to love her.

As any woman who has experienced a mastectomy will tell you, having a breast removed due to cancer is one of the most frightening experiences she will ever encounter. Until now many insurance companies denied women in the state of Texas coverage for reconstructive breast surgery, explaining their decision by saying this was an unnecessary cosmetic procedure.

On May 14, Gov. George Bush signed a bill into law giving Texas women insurance coverage for breast reconstruction after a mastectomy due to cancer. Jaime R. Garza, MD, DDS, chief of the division of plastic surgery at The University of Texas Health Science Center at San Antonio and Texas State Coordinator for the National Breast Reconstruction Advocacy Project (BRA), has been working with members of the Alamo Breast Council for the past two years to get this bill introduced into the state legislature.

"If a patient lost an eye or a nose, their insurance company would pay for reconstruction," Dr. Garza said, "and these surgeries are also considered cosmetic in nature."

State Sen. Judith Zaffirini filed SB217 and state Rep. Leticia Van de Putte filed HB262, commonly known as the BRA project, during the last session. This legislation was intended to end discrimination against women who suffer from breast cancer. All other forms of cancer- causing bodily disfigurement have historically received full coverage for reconstructive surgery--only breast reconstruction has been eliminated.The new state legislation requires insurance companies to provide coverage for reconstructive breast surgery as well as for surgery on the opposite breast to establish symmetry for both breasts. Dr. Garza says that public support for local and national legislation will encourage early detection of breast cancer and increase survival rates.

"The BRA project was a national grass roots project ," Dr. Garza said. "State coordinators at a national meeting were appointed to head up efforts in every state."

In addition, the Reconstructive Breast Surgery Benefits Act was recently introduced in the U.S. House of Representatives by Anna Eshoo, (D-Cal.) This proposal, if passed, would force insurance companies nationwide to approve breast reconstruction, prohibit insurance companies from providing rebates to policy holders who accept less than full protection, and pre-empt any state laws failing to provide coverage equal to that given under federal law. Representative Eshoo's proposal is supported by numerous professional organizations including the American Society of Plastic and Reconstructive Surgeons (ASPRS), the American Cancer Society, the Breast Cancer Coalition, and the American Medical Association (AMA).

More than l80,000 women in the United States have breast cancer yearly and approximately 85,000 undergo a mastectomy. In addition to the trauma of being diagnosed with cancer and enduring a disfiguring operation, these women must face additional psychological trauma--loss of hair, scarring, nausea and physical weakness caused by chemotherapy treatments. Many female patients put off seeing their physicians when symptoms become apparent because they dread the disfiguring mastectomy that follows a positive diagnosis.

"Several other members of the faculty and staff at UTHSCSA were asked to provide information to lawmakers as well as to Mrs. Laura Bush, who supported the measure to help get this bill passed," Dr. Garza said, "including Joel Pessa, MD, assistant professor in plastic surgery, and Sylvia Fernandez, PhD, director of the office of special programs.

"We did this for the grandmothers, mothers, wives, sisters and daughters of everyone in the state of Texas," Dr. Garza concluded. "We are proud of this accomplishment, and we want the public to be informed."

Contact: Jan Elkins (210) 567-2570