New York passes law mandating disclosure of breast reconstruction options

By Mike Stokes

08/19/2010 at 4:30PM

Breast cancer patients in New York will benefit from a new law signed by Gov. David Paterson on Aug. 15 that requires hospitals and doctors in that state to discuss options for breast reconstruction with patients before performing surgery.

An article printed Aug. 18 in The New York Times credits ASPS Candidate for Membership Evan Garfein, MD, Bronx, N.Y., as a driving force behind getting the law passed.

The article notes that Dr. Garfein, who specializes in reconstructive surgery after breast, head and neck cancer at Montefiore Medical Center, began to push for the law after learning of research that showed poor, minority women were much less likely to receive breast reconstruction after cancer than more affluent women.

"Most reconstructive surgeons are aware of the studies that have been done by Amy Alderman, MD, from the University of Michigan on the disparities in the rates of breast reconstruction based on socioeconomic and some geographic determinants," Dr. Garfein tells PSNextra. "When I got to Montefiore, I certainly witnessed that first-hand."

Shortly after his arrival at Montefiore Medical Center in 2008, Dr. Garfein says he explained the access-to-care problem to hospital administrators who helped him get in touch with legislators in Albany. State senator Ruth Hassell-Thompson and Assemblywoman Naomi Rivera sponsored the bill and it passed unanimously.

"In an era where health care legislation is really complex and complicated, this [law] was a very simple, straightforward way to help address this disparity," Dr. Garfein says. "It's good for everyone - it's obviously good for patients, it's good for hospitals because it's the right thing to do, and it's good for reconstructive surgeons as well. This seemed like a no-brainer."

He notes that a key to the success of the bill was that funding already existed through the Women's Health and Cancer Rights Act of 1998.

"We were not asking for more funding," he says. "We were just asking for hospitals and doctors to do the right thing, and that's the best part about it."

The news is particularly gratifying for ASPS, which has been spearheading a campaign advocating the need for a medical team approach in the treatment and recovery from breast cancer.

"The vast majority of breast cancer patients are missing out on a critical conversation that should take place at the time of diagnosis," says ASPS President Michael McGuire, MD. "Involving key specialists early in the process and having them work as a team allows for more coordinated care and fosters the most beneficial outcome for the patient, as the election for breast reconstruction affects the techniques surgeons use to remove the cancer."

ASPS, in partnership with the American Society of Breast Surgeons, urges breast cancer patients and their physicians to insist that their treatment be handled by a team of health care physicians with the appropriate expertise for each procedure and level of care.

"Each step of the cancer care journey requires specific medical expertise. When a team of experts works together, the outcome for patients is vastly improved," says Dr. McGuire. "However, when these specialists do not work in conjunction, opportunities are missed, and patient outcomes suffer. The problem is the Team Approach is underutilized. The ASPS is very pleased to be part of this extremely important venture along with the ASBS which represents physicians who play a critical role in the Team Approach."

Return to PSNextra.org for updates.