By Karen Powers
Women in the United States with health insurance have had the right to choose breast reconstruction after surgery for breast cancer since 1998 when federal legislation mandated that insurance cover reconstruction of the breast. The law even requires insurers to provide coverage of surgery for the other breast in order to achieve symmetry.
Despite this legislation, and even though since 1998 there have been many advances in plastic surgery techniques for breast restoration, 70 percent of women eligible for breast reconstruction are still not being informed of their options, according to a 2008 article in Cancer, the journal of the American Cancer Society.
While breast reconstruction is considered elective surgery, undergoing breast reconstruction can have profound emotional and practical benefits.
“Despite advances in the ability of plastic surgeons to restore the breast, many women are not informed that breast reconstruction is their right, and many more are not informed of their choices,” said American Society of Plastic Surgeons president Malcolm Z. Roth. “Every day, countless women around the world wake up with the fear of what life is or will be like without one or both breasts. They have a choice to have reconstruction, and we hope our message will be heard throughout the year.”
Breast Reconstruction Awareness Day was initiated last year by a group of Canadian physicians and medical professionals. This year, on Oct. 17, UTMB and other institutions around the country participated in BRA Day USA.                 
The goal of BRA Day USA is to ensure that all breast cancer patients are fully informed of their surgical options and supported by a team of medical professionals working together for the patient’s best interest. In honor of its courageous patients who have faced a breast cancer diagnosis, UTMB hosted a breakfast on BRA Day for its breast cancer patients at the UTMB Specialty Care Center at Victory Lakes.
The UTMB Breast Health and Imaging Center at Victory Lakes offers state-of-the-art breast screening, multidisciplinary evaluation, and a complete range of services and treatments related to breast health and breast cancer, including breast reconstruction. Reconstruction can be either immediate — at the same time as the complete or partial removal of the breast — or delayed. Breast reconstruction does not interfere with surveillance for breast cancer recurrence and most breast cancer survivors are candidates for immediate or delayed breast reconstruction. 
Procedures for partial breast reconstruction after lumpectomy include fat grafting and transfer of local tissue into the defect. Complete breast reconstruction techniques available include implants, transfer of tissue from another part of the body such as Deep Inferior Epigastric Perforator flaps, or a combination of implants and the patient’s own tissue.
While some women may choose not to reconstruct their breasts, all women should be informed of their options and have the opportunity to work with their physicians to develop a treatment plan that is right for them.
Dr. Karen Powers is an assistant professor of plastic surgery at UTMB, specializing in breast reconstruction.