Congress Investigates Drive-Through Mastectomies by Linda Fisher
May 23, 2008
Imagine that your left breast has just been surgically removed. You are still groggy from the anesthesia. Your neck and shoulder feel like a thousand safety pins are opening and closing with every breath you take. A tube, hanging precariously, is draining fluid from your chest. Eyes closed, you try to picture what your chest looks like now, and you hear someone standing over you say that you are cleared to go home. No matter that neither you nor your doctor agree that you are ready.
 To end this practice of drive-through mastectomies—standard operating procedure since the mid
A Personal Story
My mother, at age 86, was one victim of a drive-through mastectomy in October 2002. She died six months later.
The experience was horrific. Despite her already frail condition from several chronic ailments, and despite her daughters’ concern, she was deemed by her HMO medically ready to go home in the midst of Denver’s worst October blizzard on record. She went with a few aftercare instructions, hastily scribbled by a nurse, who also handed us a videotape. Another nurse gave us a short demonstration on how to use the lymph pump and how to re-apply bandages.
There was no thoughtful discharge plan, and it took four adult women nearly 30 minutes to get our patient into and out of the car. Pushing our frightened mother in her wheel chair through several inches of snow, we prayed that it would not overturn and tumble her into a snow bank.
There were complications almost immediately: The drainage tube became blocked and needed to be removed prematurely. She soon developed an infection for which antibiotics were prescribed. Next, she developed a chest cold. She never really got out of bed again. For the next six months, at great expense to the HMO and to Medicare, she was shuttled in and out of hospitals and a rehab center.
Finally in March 2003, after deliberating for a month and a half, all the doctors involved in her care agreed that Alice Fisher had less than six months to live and was thus eligible for hospice. After three days, she died at home, early in the morning of March 14, 2003.—Linda Fisher |
1990s—Representative Rosa DeLauro (D-CN) first introduced legislation in 1996 known as the Breast Cancer Patient Protection Act, which would require insurance providers to cover a 48-hour hospital stay if the woman and her doctor decide it is needed. Finally this week, a House subcommittee held a Congressional hearing on the measure.
The breakthrough came after the Lifetime Cable Television Network partnered with DeLauro and other organizations to call attention to the fact that private insurance no longer covered even a 24-hour hospital stay for most mastectomy patients. By last week, a network-sponsored petition to end the practice had garnered nearly 22 million signatures.
Since 1996, when several private insurance companies decided to limit the length of a hospital stay they would cover for mastectomy patients, 20 states have passed legislation of varying effectiveness to extend the recovery time. Still, 65 percent of patients are forced to leave hospitals within a few hours after surgical removal of breast tissue, muscle and lymph nodes. The DeLauro bill, which has 219 co-sponsors, would set a national standard of care. A Senate version, sponsored by Senators Olympia Snowe (R-ME) and Mary Landrieu (D-LA), has 19 co-sponsors, presidential candidates Hillary Clinton and Barack Obama among them; John McCain has not signed on.
DeLauro’s legislation has substantial bipartisan support. Representative Jo Ann Davis (R-VA) introduced a companion bill on January 4, 2007. Tragically, she died on October 6, 2007 of breast cancer before any hearings were scheduled.
Testifying at the hearing May 21, before the Health Subcommittee of the House Committee on Energy and Commerce, DeLauro noted that she had worked on the Breast Cancer Protection Act for an entire decade “without a vote or hearing ever having been called.” Now, she said, “we are at a turning point in our battle to pass this common-sense legislation.” She called on her colleagues “to meet our obligations as a nation and to make clear: we value women’s health.” A mastectomy, she said, “is not an easy surgery. It is physically and emotionally traumatic,” and adequate hospital recovery time should not be subject to negotiation.
Lifetime Television has been gathering signatures for its petition for many years as part of its “Stop Breast Cancer For Life” public advocacy campaign. One of the signers, Alva Williams of North Carolina, told the committee what happened when she was sent home several hours after her surgery in 2006. She developed an infection at the incision site, which delayed her chemotherapy treatments for six weeks.
Meredith Wagner, the Lifetime Network executive vice president of public affairs, commented that although it is an election year, “this is not about politics.” She said that mastectomy patients face “very scary, painful and emotional surgery. They deserve to have options. They should be able to go home right away if they are ready or spend a short time in the hospital if they and their doctors think this is best.”
(Click here to sign the Lifetime petition.)
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