ST. LOUIS - Despite federal law mandating insurance companies cover reconstruction after breast cancer surgery, many reconstructive surgeons say a large number of women do not have the procedure performed.

A 2007 study by the Society of Breast Surgeons found fewer than 30 percent of women get breast reconstruction after mastectomy – an even smaller percentage opt for reconstruction after lumpectomy. The reason is thought to be that many don’t know the procedure is covered by insurance companies after it was made federal law through the Women’s Health Protection Act of 1998.

“I think that is not an issue not just for women, but the surgeons and oncologists who provide breast cancer care,” says Terry Myckatyn, MD, Washington University plastic and reconstructive surgeon at Barnes-Jewish Hospital and Barnes-Jewish West County Hospital. “The idea of reconstruction after breast conservation therapy is relatively new, but it is certainly now available.”

Dr. Myckatyn says there are two subgroups of patients who are candidates for reconstruction – those who have just been diagnosed and those who have had their surgery in the past, particularly for lumpectomy.

“We can do an immediate breast reconstruction at the time of a lumpectomy,” he says. “But for others there is no ‘statute of limitations’ on when you can get reconstruction. You can get a reconstruction really any time after a lumpectomy so long as your oncologist feels you are cancer free and OK to proceed.”

At large cancer programs like the Siteman Cancer Center, Dr. Myckatyn is in the room during the surgery for breast cancer and follows up with reconstruction immediately after mastectomy or lumpectomy. However, that multidisciplinary approach is not the norm.

“This sort of phenomenon of doing immediate reconstructions is starting at major cancer centers and that’s a good advantage to have collaborations with general surgery colleagues,” he says.

For more information about reconstruction after breast cancer surgery, visit or call 800-600-3606 or visit Dr. Myckatyn and his colleagues online at www.westcountyplasticsurgeons.wustl.edu or www.barnesjewish.org/plastic-reconstructive-surgery/breast-reconstruction.