Elective Mastectomy and Reconstruction?

Question

My Mother's sister has just been diagnosed with breast cancer. Her cousin died of breast cancer under 50 and my grandmother had ovarian cancer. With this family history would I be elidgible for a double mastectomy and reconstruction? Would there even be a chance of insurance covering this?

Wandra K. Miles, MD · Answer

You may be a candidate. I recommend that you meet with a breast surgeon or oncologist who may then elect to refer you to a genetic specialist, who will be able to determine whether you meet the criteria.

Richard Baxter, MD · Answer

From your description you may be a candidate for BRCA gene testing. If you are positive, then your odds of developing breast cancer are quite high. Insurance should cover your surgery if you are BRCA positive. I would suggest finding a center where you can have skin-sparing mastectomy and direct-to-implant reconstruction with Alloderm and have it all done in one stage.

Paul Gill, MD · Answer

Thank you for your question.   I would recommend consultation with your ob/gyn or a breast surgeon for BRCA gene testing.   The unfortunate nature of this process is that only 2 genes have been discovered, BRCA 1 and BRCA 2.    We who deal with this disease frequently believe there are several genes out there not yet discovered.   

	However, if you do not test positive for BRCA 1 or 2, your insurance will not cover this procedure.  This is very frustrating and worrisome to both the patient and the doctor.   I wish you all the best in your journey.

	Dr. Gill

Sugene Kim, MD, FACS · Answer

You should consult with breast surgeon or oncologist who can assess your breast cancer risk. Given that you have family history of ovarian and breast cancer, you should be tested for BRCA gene. If you are deemed to have a high risk for breast cancer, your insurance should cover for your mastectomy and reconstruction.

Raj S. Ambay, MD · Answer

Yes! Under federal law it is covered. Also, any asymmetry is also covered to balance the breasts.

Elective Mastectomy and Reconstruction?

Answers (5)