The focus of this blog is two-fold. I will provide information regarding an upcoming public hearing concerning recent changes to insurance coverage for DIEP flap breast reconstruction. It will be held on June 1, 2023. The hearing will allow patients affected by breast cancer to become involved. I share my personal feeling that it is important for readers to understand the magnitude of this hearing regarding access to and coverage for breast reconstruction. There are many medical reasons why DIEP flap is the best recommended breast reconstruction option.
Information Regarding Public Hearing on Breast Reconstruction
Over the past few months, there has been a lot of information sharing on social media regarding coding changes to DIEP flap surgery. The collective voices sharing this information in multiple formats, coalitions formed, and no matter what organization it is from, has resulted in the public hearing held by CMS. I want to share information about the hearing and how you can become involved. The Strategic Plan as listed on the CMS website states:
CMS serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes.
CMS
Title of the Public Hearing Regarding Breast Reconstruction Coverage
Link to Virtually Join the Public Hearing
Webinar Registration: https://cms.zoomgov.com/webinar/register/WN_r_Xpc62cSt-p9CdWjBYhhA
Further information to consider for the Public Hearing on Breast Reconstruction Coverage
- This is a three-day public hearing with more than DIEP flap insurance coverage on the agenda. Be aware of this when planning attendance. I do not know what day or time the DIEP flap insurance coverage discussion will take place. I have not been able to find that specific information. The hearings take place online beginning at 9am EST.
- Anyone registering can choose to sign up to be a speaker, either “primary speaker” or “5-minute speaker” Be aware that if you choose the option to be a “primary speaker” you are asked if you will be using a PowerPoint slide show. No matter what option you choose, I encourage you to give this issue the time it deserves and plan and be prepared.
- Share your story genuinely. Why is it that DIEP flap was the best recommended breast reconstruction option for you? State the facts. Practice your talk ahead of time. Have it written down and do not worry if you read your statement during the hearing. Even in a virtual setting it is easy to get off topic and feel nervous. Preparation, Confidence, facts, and sincerity are key components to presenting your story.
- The good news is there is an option and opportunity to sign up for a “Dry Run”. I encourage you to do so.
Patient Stories: Why DIEP Flap is the Best Recommended Breast Reconstruction Option
I will share my personal story first then follow with stories from women in my community who shared their own story of why DIEP flap is the best recommended breast reconstruction option for them.
DIEP flap was the best option for me because I had prior radiation to my left breast. Prior to my breast reconstruction the radiation restricted my range of motion and caused discomfort and pain to my left axillary (arm pit) and breast area. Removing the scarring caused by radiation and replacing the radiated tissue with new, soft, warm tummy tissue from the DIEP flap alleviated the pain and greatly improved my range of motion because of my DIEP flap. If I had chosen implants, I ran the very real possibilities and was at high risk of complications around the implants because of the compromised radiated tissue prior to my DIEP flap. A year after my surgery, there was nothing more gratifying than cuddling my newborn grandson against my soft, warm, breasts.
Terri Coutee
The following comments are from the community I speak to. These are from women who are affected by breast cancer and have had breast reconstruction. I am not able to share all of them because of the amount of women who generously shared their story. So, I have selected a few.
DIEP Flap as the Only Option
- For me it was the only option. I had 13 rounds of chemo and 33 rounds of radiation for stage 3 inflammatory breast cancer. Doctors could not use my radiated skin. I am so grateful they could use the skin from my stomach to make me a new breast.
- After three failed attempts at breast reconstruction using implants, I am elated to have the DIEP flap procedure as an option. Over twelve years, I had already had to replace my implants three times due to capsular contracture, which resulted in many months of pain, lost sleep, limited range of motion, and nerve damage. While I am only five days out from my DIEP procedure, my teen daughter is already amazed at how different my breasts feel. She was a toddler when I went through treatment and my initial implant reconstruction has always known that hugs from Mom felt different than hugs from Grandma or friends’ parents. When I gave her a gentle hug this afternoon, she commented that the hard rocks were finally gone from my chest. Even without radiated tissue, my body never accepted or healed correctly around breast implants.
- After my double mastectomy, I lost one of my tissue expanders to infection/complications. Then my oncotype score indicated I would need chemotherapy and radiation. When radiation increased the chances for complications and capsular contracture, it became clear that expanders to implants was not the ideal choice for my body. I am young and reconstruction surgery is important to me. I choose DIEP flap and will need it in 2024. I greatly need CMS to reconsider!
The Reasons are Clear for Having DIEP Flap Breast Reconstruction
There are thousands of stories about why DIEP flap is the best recommended breast reconstruction option for women affected by breast cancer. We have an opportunity to share our voices now to protect access to the latest and most advanced form of breast reconstruction available.
I encourage you to sign up to attend the hearings and to speak up to share your story. My hope is the information and stories provided here will assist you in this decision. DiepCFoundation supports the right to reconstruct, access to health care, and fair and complete insurance coverage for DIEP flap breast reconstruction.