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Topic: Prophylactic Mastectomy 8 Years Later?

Forum: Employment, Insurance, and Other Financial Issues —

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Posted on: Apr 22, 2021 10:08AM

Ukkate wrote:

My Oncologist told me that my risk of a secondary cancer was pretty high and said that I ought to get my breast removed at some point (he recommended at the 10 year mark when I would likely have my implant replaced). I'm 8 years out now and I made an appointment with the breast surgeon (my surgeon retired) and he said that insurance would likely deny this without a genetic risk. He's referring me for genetic testing but has anyone been successful getting this so many years later? My insurance information is vague.and talks about different risk calculators (which aren't applicable if you've already had BC).

Let me know if you've gone though this.

Dx 3/7/2013, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER-/PR-, HER2+ Surgery 4/10/2013 Mastectomy: Left Targeted Therapy 5/13/2013 Herceptin (trastuzumab)
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Apr 22, 2021 12:54PM Dani444 wrote:

I had a preventative mastectomy a couple years after my UMX. I know that’s not as long as what you are dealing with. I had no trouble with my insurance covering it and my genetic testing was negative. I am sure they would have a way with your high risk to justify it to the insurance. I hope you have a good meeting with your surgeon, I understand all insurance companies are different but I hope they can appropriately advocate for you.

DX @ 46, premenopausal, mammaprint low risk Dx 8/21/2018, LCIS/ILC, Right, 4cm, Stage IB, Grade 2, 2/3 nodes, ER+/PR+, HER2- (IHC) Surgery 10/24/2018 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Silicone implant Radiation Therapy 12/5/2018 Lymph nodes, Chest wall Surgery 8/19/2020 Prophylactic mastectomy: Left; Reconstruction (left): Silicone implant Surgery 4/18/2021 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 23, 2021 07:04AM Ukkate wrote:

Thanks for responding. It was the surgeon that gave me the "brush off". My original surgeon has retired and I feel like she would've fought harder for me. I'll talk to my oncologist (who recommended this in the first place!)

Dx 3/7/2013, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER-/PR-, HER2+ Surgery 4/10/2013 Mastectomy: Left Targeted Therapy 5/13/2013 Herceptin (trastuzumab)

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