Ask the DoctorThis week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions. Q: Both my mother and my aunt have been diagnosed with breast cancer. If I were to get a mastectomy, would it be covered by insurance in the state of Pennsylvania?A: The situation with “high risk” patients and prophylactic mastectomy seems to be evolving. If you are tested and found to have the BRCA gene, most or all insurers seem to be covering mastectomy and reconstruction. Even if you do not have the BRCA gene, but have a strong family history such that your medical oncologist recommends mastectomy, your insurer may well cover it. There may be other laws specific to this in the state of Pennsylvania of which I am not aware, but possibly Gail, our office manager and insurance specialist, can help you more.Q: I had breast cancer in my right breast, and received a double mastectomy in November. They placed expanders in both. I didn't have any trouble on the left side. However, six surgeries later, I opted to have my right-side expander removed. It feels better. However, I am now scared to undergo reconstruction due to this past trouble with my right expander. I still have the expander in my left breast. Any advice for me? Is it common to have trouble with expanders? A: Sorry you are having trouble. Unfortunately, trouble with expanders is pretty common. It’s more likely if you were radiated on the “problem” side, but it also happens with some regularity even if you aren’t radiated. Fortunately, previous trouble with expander or implant-based reconstruction does not adversely affect your ability to have natural breast reconstruction using your own tissue. Many of our patients come with stories very similar to your own, some already having had over 10 surgeries, and almost all have subsequently achieved satisfactory, natural-feeling reconstructions without the use of implants. I think there is an excellent chance that we can help you. If you wish, we can have our nurse Chris or P.A. Kim call you to discuss the specifics of your situation in more detail.Dr. Richard Kline Center for Natural Breast Reconstruction

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