Despite the increase in breast-reconstruction procedures performed in 2008, nearly 70 percent of women eligible for this procedure are not even told about the reconstructive options available to them, according to a recently published report. Yes, I know it's hard to believe, but that number is 70 percent.

Missing the conversation
Newly released statistics by the American Society of Plastic Surgeons (ASPS) show that more than 79,000 breast-reconstruction procedures were performed in 2008--a 39 percent increase over 2007. (See: Should you have breast reconstruction after a mastectomy?) In spite of these facts, current research suggests that many breast-cancer patients are missing out on a key conversation, a conversation that should have taken place way back when the diagnosis was made.

A mastectomy patient's bill of rights
When women need to undergo mastectomy surgery for treatment of their breast cancer, they need to be told about the option of reconstructive surgery before the surgery. Then, after the surgery, they are entitled to have that reconstruction performed. A federal law was passed in 1998 requiring that insurance companies cover this type of procedure, and not treat it as cosmetic surgery. Still, women are not being universally offered the option to have their breasts rebuilt.

Why is this happening?

• The surgeon's office staff are more inconvenienced when they have to coordinate their operation room schedule with that of another surgeon--in this case, a plastic surgeon.
• Out of habit and history, some general surgeons aren't accustomed to doing cases with another surgeon.
• Still others don't believe that reconstruction is important.

This last "reason" is uncaring and false. Having her silhouette be whole again is invaluable to a woman's psychological wellbeing and self image.

Speak up
Women need to be educated about this and to be encouraged to speak up if they are not being told of the reconstruction options when undergoing mastectomy surgery. They also need to be informed about all the options, and not be limited merely to having an implant or a TRAM-flap reconstruction. The best procedures being done today are DIEP-flap reconstruction and S-GAP reconstruction. (See: Tissue Flap Surgery for Reconstruction.)