Legislation by New Orleans Democratic Sen. Troy Carter would require hospitals and doctors to better educate breast cancer patients about reconstructive surgery options ahead of treatment.
Breast cancer patients whose insurance plans cover mastectomies are guaranteed insured reconstructive surgery under the federal Women's Health and Cancer Rights Act of 1998, but many patients are undereducated by physicians, Carter said. Research shows seven in 10 women are not properly educated about reconstruction before undergoing surgery, he said.
Reconstructive surgery is currently covered by private insurance, Medicare and Medicaid.
Senate Bill 556 would require all hospitals and doctors providing mastectomies, lumpectomies and lymph node dissections to inform patients about the advantages and disadvantages of various reconstructive options, the federal and state provisions ensuring insurance coverage of reconstructive procedures, and options for accessing reconstructive care before receiving consent for procedures. Kenner Republican Rep. Julie Stokes, a breast cancer survivor.
Carter was inspired to bring the bill after his niece Chontel Carter Frank, sister of Rep. Gary Carter, D-New Orleans, underwent a prophylactic hysterectomy and prophylactic double mastectomy with reconstruction in 2017. Frank’s mother, Constance Carter, died in 2008 after a battle with ovarian cancer.
Frank said she was tested for hereditary cancer risks and was told she had an 85 percent chance of developing breast cancer and a 50 percent chance of developing ovarian cancer before 50. As she explored her preventative surgery options, Frank, a nurse practitioner with a background in pediatric surgery, wasn’t happy with the invasive surgery procedures her physicians proposed, she said.
Frank demonstrated on her uncle the four to five incisions doctors proposed making on each of her breasts for committee members. Educating herself on the issue, Frank found a less invasive alternative suitable for low risk cancers and preventative procedures and pitched the concept to her doctors.
The mother of two said lack of a medical background shouldn’t prevent patients from knowing what treatments are available to them. Maintaining health while having the best quality of life possible should be an option for patients of all backgrounds and socioeconomic means, she said.
“I am here today because everybody knows cancer, everyone knows someone who has cancer and we all know that we do not want cancer,” Frank said.
Kim Sport, a breast cancer survivor and co-founder of breast cancer non-profit Breastoration, said physicians are already required by a 1999 state law to inform patients about their alternative treatment and reconstruction options, but many do not. The state issued an educational pamphlet in 2000, but it quickly became defunct until Sport and Breastoration partnered with the Department of Health and the Louisiana Board of Medical Examiners to issue a revamped pamphlet in 2014.
Sport said the law dictates the booklet is updated every three years and that physicians record the date and time the information is relayed verbally and in writing on all patient medical records. Carter and Stokes’ measure is an important step to increasing accountability and improving access to education, she said.
In 2016, Gov. John Bel Edwards signed into law a bill by Rep. Helena Moreno, D-New Orleans, that cleared insurance impediments for breast cancer patients seeking reconstructive surgery.
The law clarified breast reconstruction surgery can never count as cosmetic surgery, mastectomy and reconstruction surgeries do not have to be completed under the same insurance plan, and an insurance plan cannot dictate what type of breast reconstruction procedure their plan will cover.
Sport said it’s past time this was common knowledge for patients.
“I think it’s an absolute tragedy a woman in this day and age doesn’t know that breast reconstruction is an insured option following a mastectomy,” she said.