CHICAGO (October 11, 2019)—As we kick off Breast Cancer Awareness month, Senator Tammy Duckworth (D-IL), lead sponsor for S.562, the Breast Cancer Patient Equity Act, visited Second Act Mastectomy Boutique in Chicago to meet with breast cancer survivors.

Duckworth heard personal stories from several breast cancer survivors, some of whom have had access to custom breast prostheses through private payers that allow coverage and others who have been denied access either through the VA, Medicare or private payers that follow Medicare guidelines.

These impactful personal stories included issues with contoured chest walls that are difficult to fit with off-the-shelf breast forms. One of the women explained that after surgery the assumption is women will have a smooth flat surface. Unfortunately, that is seldom the case. She self-described her chest wall as a topography map where off-the-shelf breast forms do not stay in place. Another woman discussed the difficulty of finding an off-the-shelf prosthesis to match her existing breast. After trying so hard to find a solution that would most closely match her profile, she was disappointed to see her reflection in a mirror while doing a yoga class and realizing her breasts were still unbalanced. And these are just some of the many cases where custom breast prostheses would better match their needs.

Other women present had experiences with extra tissue in some areas of their chest and gaps in other areas that would be best fit with a personalized prosthetic. Several attendees agreed they had to change their style of clothing and explained how their self-confidence had suffered.

Pattie Cagney Sheehan, owner of Second Act Mastectomy Boutique, and a Certified Mastectomy Fitter, showed Senator Duckworth the differences in construction and weight between off-the shelf breast prostheses and the personalized, custom breast prostheses, and explained the difference in reimbursement rates. One of the ladies pointed out how custom breast prostheses would represent a cost-savings to surgical reconstruction.

Retired Lt. Col. Jennifer Pritzker opened the event by stating that she partnered with Sheehan and Second Act because there is a real need to provide breast cancer survivors with prosthetics and related products that will allow them to feel the way they want to feel, and live the way they want to live, restoring their self-confidence during, and after, their life changing journey.

She went on to state that she finds the strength of breast cancer patients inspirational and that all women deserve the option to choose what works best for them. “After all,” she said, “breasts are essential to a woman’s body, identity and function so why should breast prosthetics be treated any differently than a loss of an arm, or a leg? This legislation will go a long way in helping women with their breast cancer recovery and getting back to living their full lives.”

The Breast Cancer Patient Equity Act would allow Medicare to recognize custom breast prostheses as an eligible benefit. Custom breast prostheses have a Medicare billing code and fee schedule in place. However, at this time, Medicare only pays for off-the-shelf breast prostheses and surgical reconstruction following breast cancer surgery. While these choices are sufficient for many women, there are others in need of an alternative that fits in the middle. A solution personalized to fit their post-surgery chest wall and yet not invasive like a surgical procedure.

Nikki Jensen and Tom Powers from Essentially Women, a division of the VGM Group, also attended the event. Jensen described the event as a “wonderful opportunity for Senator Duckworth to hear directly from constituents on the importance and impact of passing this legislation for breast cancer survivors.” Powers expressed his gratitude to Senator Duckworth for introducing this legislation and for her work on behalf of breast cancer patients. When asked what the chances are of passing this legislation, Senator Duckworth commented breast cancer is bipartisan and she is hopeful this bill will pass.

The Breast Cancer Patient Equity Act is co-led in the Senate by Senator Lisa Murkowski, (R-AK). The House companion bill, H.R. 1370, is a led by Representatives Judy Chu (D-CA) and Jackie Walorski (R-IN).

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