Question:
Lump in breast, if insurance pays for removal could I add reconstruction?

Last week I found a lump in my breast. I had one removed 7 years ago. I am only 30 years old, but have lost several family members to cancer. Mamo was done, but no results yet. They wanted to do an ultrasound and most likely a biopsy. I have been fighting with insureance already for a tummy tuck and lipo. I didn't really care about the chest until now, but it was submitted along with all the other things. Since there is a possiblity of having surgery on my breast anyway, would insurance cover the reconstruction part of it as well to "put them back where they belong" I could care less about size or implants, I just want them to not look like a nylon bag with an orange at the bottom. I have BCBC/ IL PPO insurance that willingly paid for the RNY, but is stalling about giving me a yes or no with tummy tuck and other plastics. They have been asking for more documentation of rashes and hernia (which I don't have), so I am guessing they will deny as it stand currently. Just rambling...don't even know if there is a real question in all of this.    — Heather M. (posted on May 14, 2005)

May 14, 2005
Heather, well I hope this post will help you a bit, but because you've had a lumpectomy done already, MOST insurances will approve breast reconstruction! In doing so they HAVE to take skin from somewhere else on your body. Most PS will take from your stomach thus causing your insurance to APPROVE a tummy tuck! Look into it because I'm sure every insurance company is different, but it happened for a friend of mine!
   — Carole M.

May 15, 2005
The law requires that breast reconstruction be provided for mastectomies but not lumpectomies. If you have to have a mastectomy, as I did, you can have your new "breast" made from your abdomen and that way, you will get a free tummy tuck with it. It is a Federal law that requires the reconstruction surgery so it's available in every state. It also requires that both breast end up looking similar so if your new breast is perky, they have to perk up the existing breast, free of charge. Feel free to e-mail me if you have any questions. I am a one year survivor of breast cancer post RNY.
   — GailV

May 19, 2005
Hi. A lumpectomy wont likely require reconstruction, its usually a mastectomy that would qualify you for breast reconstruction, which hopefully you will not need. I would be hesitant to do ANYTHING to a breast until I was sure the cancer issue was solved. If a woman has a mother, sister, or daughter with a BREAST cancer diagnosis, especially at an early age, then screening and sometimes surgery are needed. I might combine a cosmetic procedure with a breast lumpectomy if I were 90% sure the lump seemed benign before surgery, and 100% sure after I removed it and had path look a it IN surgery.
   — DrL