Since 1998, it’s been the law in New York State, that health insurance covers the costs of breast reconstruction for cancer patients who undergo a mastectomy. And while doctors will tout the benefits of the surgery, many women who are eligible don’t seek the procedure — often because they don’t know enough about it.

Now, a state bill signed into law this summer mandates that doctors discuss reconstructive options with patients, before they start treatment.

“Women who undergo mastectomy for breast cancer get reconstructed at widely different rates, based on their socio-economic and racial profiles,” said Dr. Evan Garfein, a plastic surgeon at Montefiore Medical Center who authored the new law.

He noticed that low-income women and women of color are less likely to get the procedure done because they are uninformed, or because they aren’t aware that their insurance will pay for it.

“You don’t have to get reconstructive surgery — that’s a personal choice,” Garfein said. “But you do have to know about it. It’s part of the standard of care, and like any other treatment, you have to know about it to make an educated decision.”

For a number of reasons, Garfein said, of the thousands of women who get a mastectomy each year, only 30 or 40 percent opt for reconstruction. In some low-income communities, he estimates the number could be as low as 15 percent.

Dr. Burt Petersen, a breast surgeon at St. Barnabas Hospital, says that some doctors won’t tell their patients about the procedure because they don’t have plastic surgery support at their practice, or because their plastic surgeon doesn’t accept insurance or Medicaid.

“Rather than refer the patient to a breast surgeon that can do the reconstruction, they opt not to tell the woman about that option because they don’t want to lose the business,” Petersen said. “That’s a harsh reality. It’s unethical, and it’s bad medical practice.”

Breast reconstruction can cost anywhere from $10,000 to $25,000, depending on what kind of procedure is done, Petersen says. The surgery is not for everyone, but can have a number of emotional benefits to a patient recovering from breast cancer.

“Women who feel better about themselves do better, and are more likely to follow up,” he said. “It has a tremendous impact on the health and well being of the patient.”

For patients who can’t afford to pay for the surgery out of pocket, Petersen recommends seeking care at a teaching hospital or center associated with a medical university, as those are more likely to accept insurance or Medicaid. 

Ed. Note: October is breast cancer awareness month. The nonprofit Cancer Care also offers a number of resources to breast cancer patients. Visit www.cancercare.org or call 1 (800) 813-HOPE (4673) for more information.