#BreakTheBias with Custom Prosthetics on International Women's Day

Published in Member Communities on March 04, 2022

Today is International Women’s Day. International Women’s Day is an internationally recognized holiday that has been observed since the early 1900’s, bringing light to women’s issues across the globe.

The global day celebrates social, economic, cultural, and political achievements of women and also marks a call to action for accelerating gender parity. Gender parity is about reducing discrimination, bias, and stereotypes against women, promoting equality between men and women.

This year’s theme is #BreakTheBias. Women see biases in our communities, workplaces, and some healthcare policies. One of the most egregious healthcare policy biases relates to custom breast prosthetics.

If a woman undergoes a mastectomy due to breast cancer, she has four choices for breast replacement: surgical breast reconstruction, off-the-shelf breast prosthetics, custom breast prosthetics, or to go flat. But one of these options is not covered by Medicare.

Currently, Medicare deems custom breast prostheses as not medically necessary. The breast is one of the few body parts not covered by Medicare as a custom replacement, taking this option away from women who rely on Medicare for their health insurance. No two women are the same. Women deserve to choose the breast replacement option that works best for them.

Essentially Women and the Let Her Decide campaign have gathered many stories from women who have demonstrated a need for custom breast prosthetics after a mastectomy:

• Jacqueline Cromity was diagnosed with stage 3 breast cancer with two tumors. After a lumpectomy and a breast reduction, she was fitted for an off-the-shelf prosthetic that did not match her skin tone or the size of her remaining breast. If provided the option, a custom prosthetic would have been able to match her shape, unique chest wall, and skin tone. As a woman of color, the pink off-the-shelf prosthetic is not an ideal breast replacement option.
• Jamie Lee underwent surgical reconstruction after a bilateral mastectomy, but developed such a severe infection with her expanders that she almost died due to the infection. Jamie did not want to undergo additional risky surgeries, so opted for prosthetics instead. She tried off-the-shelf prosthetics; however, they didn’t allow her to return to her normal daily activities or provide the mental health benefits that custom prosthetics could provide.
• Renee Firato has undergone multiple rounds of chemo and surgeries due to a previous cancer diagnosis at the age of 18. At the age of 35, she was diagnosed with breast cancer and underwent a mastectomy. Due to her previous surgeries and bouts of chemo, she is not a candidate for surgical reconstruction at this time, so prosthetics were her only option. Off-the-shelf prosthetics were uncomfortable and did not fit against her chest wall or where she was missing tissue. Being fitted for a custom prosthetic allowed Renee to find a more comfortable fit for her and her lifestyle.
• Cheryl was diagnosed with breast cancer in 2004. After a lumpectomy and radiation treatments, she was in remission for several years. However, in 2015, she was diagnosed with invasive breast cancer on the same side where she had her mastectomy. During the course of chemo treatments, she kept getting infections at the incision site. The infections lead to several additional surgeries. On top of surgery, she had 8 months of chemotherapy. Once finished with chemo, she was fitted with an off-the-shelf breast prosthesis. Cheryl was fitted with a larger off-the-shelf prosthetic to match her remaining breast. Unfortunately, the off-the-shelf prosthetic did not match her remaining breast, was cumbersome, and caused additional pain because it rubbed against scar tissue.

If passed, the Breast Cancer Patient Equity Act (H.R. 3087 / S. 2051) would provide coverage for custom fabricated breast prostheses—which, unlike other prosthetic devices, are not currently covered by Medicare—to the more than 100,000 women who undergo mastectomies annually. Many private insurance companies follow Medicare guidelines, that’s why this legislation is so important. 

On International Women’s Day, we urge everyone to urge their members of Congress to #BreakTheBias and to sign on to support the Breast Cancer Patient Equity Act. Take action at letherdecide.org.   

TAGS

1. cms
2. orthotics & prosthetics
3. women's health