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Pa. women applaud new breast cancer law

November 26, 1997

By LISA GRAYBEAL

Staff Writer, Chambersburg

CHAMBERSBURG, Pa. - Doctors discovered a malignant tumor in 34-year-old Kathy Grove's right breast last year.

The Greencastle, Pa., wife and mother of four young children faced a radical mastectomy, or surgical removal of the breast, followed by a series of chemotherapy sessions.

Grove said statistics place women in her age group at a low risk for breast cancer, "so it really was a shock to me" when she was diagnosed with the disease.

On March 4, Grove underwent a 10-hour operation during which her breast was removed and reconstruction work done using muscle, tissue and skin taken from her abdomen.

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"I wanted it all done at one time - right away," Grove said.

The expensive procedures were covered under Grove's health insurance, which allowed her to stay in Geisinger Medical Center in Danville, Pa., for four days after surgery.

"I was told not to feel like I had to leave. I didn't have to leave until I was ready, and that's how it should be," because of the physical and emotional impact of losing a breast, she said.

Now a new law in Pennsylvania, signed by Gov. Tom Ridge on Nov. 4, requires all insurers to fully cover mastectomies as inpatient surgery and to provide coverage for reconstructive surgery and/or prosthetic devices to establish symmetry between a woman's breasts.

The law also extends the time frame in which a woman can have reconstruction from two to six years.

Mastectomies previously were considered outpatient surgical procedures and covered as such by insurance companies. Patients often went home within hours of the surgery because their insurance policies wouldn't cover an overnight stay. Procedures handled in that way came to be known as "drive-by mastectomies," said Connie Woodruff, executive director of the American Cancer Society's unit in Franklin, Fulton, Adams and York counties.

Reconstructive surgery was considered cosmetic surgery until the new law was passed.

"We're glad to see that reconstruction is also part of the law because it's very important for a woman's psychological well-being," Woodruff said.

The new law puts health care back into the hands of the woman and her doctor, she said.

Sharon Brosious, Franklin County's captain of the Pennsylvania Breast Cancer Coalition, collected more than 500 signatures on a petition in five days and called local legislators urging them to endorse the bill.

"When someone loses their arm and they get a prosthesis, they don't call that cosmetic surgery. It's the same thing for a woman who loses her breast," Brosious said.

Although the insurance industry as a whole supported the legislation, agents warn their clients that the new law means charging higher insurance premiums.

"For the clients, it (the law) is a good idea. But we (insurance agencies) have to collect a higher premium to pick up the loss," said Donald R. Myers, a Fayetteville, Pa., insurance agent.

Clients weren't covered for mastectomies as inpatient surgery before the law was passed because it kept costs down, Myers said.

"We are out there to do the best we can for our clients. These are good laws, but it costs more money," he said.

Pennsylvania is the 12th state to pass such a law.

The state has the fourth highest rate of breast cancer in the United States, striking approximately 10,500 women each year, according to statistics from the state Health Department. There are about 2,600 breast cancer-related deaths in the state annually, the statistics show.

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