By Marcy Sanchez, WBAMC Public Affairs:
(El Paso, Texas, Oct. 19. 2017)
William Beaumont Army Medical Center hosted a Breast Reconstruction Awareness (BRA) Day informational booth to promote education, awareness and access for women considering post-mastectomy breast reconstruction Wednesday.
Since 1998, The Women’s Health and Cancer Rights Act has mandated that health plans which offer breast cancer coverage to also cover reconstruction and prostheses for patients. Although the law has been in place for almost 20 years, almost 70 percent of patients were not informed of reconstructive options after treatment until much more recently.
“The goal is to educate the public, our patient population and our fellow physicians (on reconstruction options),” said Lt. Col. Owen Johnson III, chief, Plastic and Reconstructive Surgery Service, WBAMC. “Patients with a diagnosis of breast cancer or severe benign breast diseases are supposed to be offered the opportunity to speak with a plastic surgeon about what reconstructive options they have.”
WBAMC’s second annual BRA day, hosted nation-wide every third Wednesday of October, welcomed beneficiaries to visit with Plastic and Reconstructive Surgery Service nurses and surgeons to discuss the latest technology implemented at WBAMC for patients. Some of the latest initiatives include 3-D reconstructive/plastic surgery simulator application, a first of its kind in the Army, which offers patients increased engagement in their own reconstructive planning.
“(The 3-D simulation) takes concepts from Computer-Assisted Design and applies it to surgery,” Johnson said. “For patients who are nervous and don’t know what to expect, it’s a way for them to digest (reconstruction surgery) a little bit more. It may help them choose an option with more confidence and put them at ease with their decision.”
When patients are diagnosed with breast cancer, physical and emotional stress impact treatment and recovery, Johnson said. Giving patients the option for reconstruction may help them feel better during that process.
A few years ago, Dawn Wright, a retired Soldier, didn’t have many options after undergoing a double mastectomy.
According to Wright, she was referred to a specialist who outfitted her with a surgical bra following her mastectomy. Wright was never really given options in her post-surgical recovery. She followed her doctor’s orders during her recovery and reconstruction, which led to disappointing results.
“I hear that all the time, someone is bombarded with information and options and don’t really know where to begin,” Johnson said. “They need to be well educated and well informed about the options and potential problems that could come their way.”
“I wish I would have known (options available) a long time ago,” Wright said. “(Women) need to look at options; don’t decide after the first advice you get. Listen, get more opinions and get options.”
It wasn’t until recently that Wright received care tailored to her needs and wants, receiving autologous reconstruction to correct the previous reconstruction procedures.
The reconstructive options, different for each patient, comprise three main modalities: implants, autologous reconstruction (meaning using tissue from other parts of the body to re-build the breast) and autologous tissue with implant. Patients can opt to have immediate, post-lumpectomy/mastectomy reconstruction or delayed reconstruction (performed months to years after completing cancer treatments).
“It’s important to have a discussion (about options with patients) before we start treatment for whatever the problem is because the type of reconstruction we choose might influence how the (cancer/disease) is treated in the first place,” said Johnson. “That’s always been the problem in an underserved community where people may undergo certain types of surgery, chemo, radiation for their breast cancer. A year later patients may want to talk about options, but all those options may not be available anymore.”
According to the American Cancer Society, only about 5 percent of women choose to undergo immediate breast reconstruction at the time of mastectomy.
“I tell people a very viable option may be for them to do nothing,” Johnson said. “That’s OK as long as they choose for themselves.”