Congress Investigates Drive-Through Mastectomies

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 mid1990s—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.”