Non-Surgical Alternatives to Breast Reconstruction

• By John P. Bachner, Julie E. Janson
• Sep 01, 2003

As a three-year breast cancer survivor, I know first-hand what women go through when they are faced with treatment and post-treatment options. Sometimes those options feel more like mandates when it comes to the cosmetic side of recovery--especially following a mastectomy.

Many doctors are quick to direct patients to a plastic surgeon for breast reconstructive surgery. While it is a viable option for some women, breast reconstruction holds numerous risk factors.

Today, there are new advances in external breast prosthetics that enable survivors to have a customized fit. Post-mastectomy patients can take advantage of a breast prosthesis that feels like an extension of their own body, without any more invasive surgeries or risk factors.

Thanks to these new advances in external breast prostheses, post-mastectomy patients represent a significant potential market for home medical equipment providers.

Every year, close to 200,000 women are diagnosed with invasive breast cancer. According to American Cancer Society and other industry sources, the incidence of breast cancer is expected to grow 2 percent annually, reaching 270,000 by 2010. Moreover, the World Health Organization estimates that over 1.2 million new cases will be diagnosed worldwide.

It is estimated that approximately 90,000 of these women will undergo a mastectomy as a part of their treatment for breast cancer. Of these women, about one third will have reconstructive surgery, the remaining women will either do nothing or wear an external breast prosthesis.

Reconstruction Risks

While it has seen mixed results, breast implantation has been a common surgical procedure in the US since the mid-1970s. In the next two decades, the procedure became surrounded by controversy as women began experiencing complications with their breast implants. In fact, in 1992, the FDA placed a ban on the general use of silicone gel breast implants after a significant number of safety concerns arose. Today, plastic surgeons have been given approval to resume using silicone gel breast implants, but safety studies continue. The FDA simply recommends that potential breast implant candidates are aware of the existing safety concerns before making a decision.

There are several adverse side effects with breast implants including hardening of scar tissue around the implant, rupture and leakage, hematomas, calcium deposits in the tissue surrounding the implant, infection and implant shifting.

There are also concerns about the implants interfering with mammograms, potentially hiding new cancerous tumors.

Reconstruction Redux

These problems, as well as many others, lead to the need for additional operations. In fact, an October 2002 report from Imaginis Breast Health News says that, 43 percent of breast cancer patients who underwent breast reconstruction with implants require additional surgery.

And when you factor in weight fluctuations and the effects of gravity, some reconstruction patients find themselves wishing for additional surgeries for cosmetic reasons. In a breast cancer survivor's lifetime, it is not unlikely to have two to three subsequent surgeries for these reasons.

Non-surgical Options

Mastectomy patients now have new options when trying to return to their natural look. New technology in custom-made breast prosthetics can replicate the woman's exact shape and create symmetry with the intact breast for single mastectomy patients.

Breast cancer survivors do have a choice when it comes to custom-made prosthetics. They can choose one of two options laser scanning technology or a plaster casting technique. Plaster casting requires that the subject sit very still for two hours in about 1 0 pounds of a cold, wet goo. It is not only time consuming, but if the patient moves during two hour process, the measurements can become inaccurate and the woman will have to go through the entire process again.

The laser scanning option requires that the woman stands still for less than two minutes while a compact laser device scans their surgical site and intact breast, instantly transferring the 3-D image to a computer screen.

After it is captured in the computer, technicians can rotate the 3-D image to examine it from other perspectives and create a breast prosthesis that takes into consideration every precise detail of the woman's chest area anatomy.

Custom breast prosthetics also offer women several benefits. The right prosthetic can help the psychological and emotional well being of breast cancer patients. If they feel better about the way they look, it can make the recovery process much easier.

Cost Comparison

Reconstruction can cost upwards of $15,000 for each surgery. Given the number of subsequent surgeries needed by many women, the costs can become staggering.

Custom prosthetics cost less than $3,000. Even if a woman replaces her custom prosthesis every other year for the next 10 years, the cost can be less than just one of the reconstructive surgeries.

The Women's Health and Cancer Rights Act of 1998 requires that insurance companies reimburse for breast prosthetics. Fortunately, most private insurance companies realize the medical necessity and benefits of a custom form and cover the majority of the expenses. Most private insurance companies will reimburse a custom prosthesis at 80 percent.

Providing women the option of adequate reimbursement for a custom prosthesis can result in substantial savings to insurance providers over the cost of reconstructive surgery.

What this means for HME Dealers

This information will equip you with the tools you need to communicate the benefits of a custom breast prosthesis to customers considering their post-mastectomy options.

It is unfortunate that the size of the breast cancer market is growing. As HME dealers, you have an opportunity to help women who could benefit from a custom-fitted breast prosthetic.

This article originally appeared in the September 2003 issue of HME Business.