,,ii  #aac? ,,congress  #a/ ,session    
,s4 #ica  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,may #ac1 #bjac ,mr4   
,blunt 7= himself1 ,mr4 ,br[n1 ,mr4     
,te/]1 & ,mrs4 ,fe9/e97 introduc$ !     
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,heal?1 ,education1  
,labor1 & ,p5sions  ,a ,,bill  ,to am5d 
! ,public ,heal? ,s]vice ,act to raise  
aw>5ess (1 & to educate brea/ canc]     
pati5ts anticipat+ surg]y1 especially   
pati5ts :o are memb]s ( racial & e?nic  
m9ority gr\ps1 reg>d+ ! availability &  
cov]age ( brea/ recon/ruction1          
pro/heses1 & o!r options4  #a4 ,%ort    
title ,?is ,act may be cit$ z ! ,brea/  
,canc] ,pati5t ,education ,act ( #bjac4 
#b4 ,f9d+s ,congress makes ! foll[+     
f9d+s3  7#a7 ,! ,am]ican ,canc] ,society
 e/imates t 9 #bjac1 ab\t #bcb1cdj new  
cases ( brea/ canc] w be diagnos$ 9     
,am]ican wom54  7#b7 ,brea/ canc] has a 
disproportionate & detrim5tal impact on 
,african-,am]ican wom5 & is ! mo/ common
 canc] among ,hispanic wom54  7#c7      

,african-,am]ican wom5 "u ! age ( #dj h 
a great] incid5ce ( brea/ canc] ?an     
,caucasian wom5 ( ! same age4  7#d7     
,accord+ to ! ,heal? ,res\rces &        
,s]vices ,adm9i/ration1 wom5 resid+ 9   
rural areas may h l[] rates (           
mammography scre5+ comp>$ to non-rural  
wom5 because ( b>ri]s to heal? c>e1 su* 
z great] di/ances to m$ical facilities &
 l[] educational1 income1 & heal?       
insurance levels4  7#e7 ,individuals    
und]go+ surg]y = brea/ canc] %\ld h !   
opportunity to give due consid]ation to 
! option ( brea/ recon/ructive surg]y1  
ei!r at ! same "t z ! brea/ canc] surg]y
 or at a lat] date4  7#f7 ,accord+ to ! 
,am]ican ,canc] ,society1 imm$iate brea/
 recon/ruction (f]s ! advantage ( comb9+
 ! brea/ canc] surg]y ) ! recon/ructive 
surg]y & is co/ effective1 :ile delay$  
brea/ recon/ruction may be advantage\s 9
 wom5 :o require po/-surgical radiation 
or o!r treatm5ts4  7#g7 ,a woman :o has 
_h a brea/ remov$ may n be a c&idate =  
surgical brea/ recon/ruction or may     

*oose n to und]go additional surg]y &   
in/ead *oose brea/ pro/heses4  7#h7 ,!  
,wom5's ,heal? & ,canc] ,rights ,act (  
#aiih 7,,:cra2 ,public ,law #aje-bgg7   
requires heal? plans t (f] m$ical &     
surgical b5efits ) respect to a         
ma/ectomy to also provide cov]age = all 
/ages ( recon/ruction ( ! brea/ on :i* !
 ma/ectomy has be5 p]=m$1 surg]y &      
recon/ruction ( ! o!r brea/ to produce a
 symmetrical appe>ance1 pro/heses1 &    
physical complications ( ma/ectomy1     
includ+ lymph$emas4  7#i7 ,a #bjjg /udy 
by ,amy ,ald]man1 ,m4,d4 at ! ,univ]sity
 ( ,mi*igan report$ t up to #gj p]c5t ( 
wom5 eligible = brea/ recon/ruction are 
n in=m$ ( _! recon/ructive options by _!
 g5]al surgeon4  7#aj7 ,a #bjjc /udy by 
,ald]man & o!rs f\nd t race is a        
significant pr$ictor ( recon/ruction4   
,comp>$ ) ! odds ( recon/ruction =      
,caucasians1 ! odds ( recon/ruction =   
,african-,am]icans1 ,hispanics1 &       
,asians are significantly less4  7#aa7  
,a #bjjg /udy by ,caprice ,gre5b]g1     

,m4,d4 ( ! ,dana ,f>b] ,canc] ,in/itute 
& o!rs f\nd t ,hispanic pati5ts 7 less  
likely to receive recon/ruction4 ,?is   
may be because ( language b>ri]s betwe5 
! pati5t & provid]4 ,al?\gh #gb p]c5t ( 
pati5ts :o prim>ily spoke ,engli% w5t on
 to receive recon/ruction aft] discuss+ 
x ) _! provid]s1 no pati5t 9 ! /udy ) a 
prim>y language o!r ?an ,engli% w5t on  
to receive recon/ruction4  7#ab7 ,a     
#bjji /udy by ,ald]man & o!rs also f\nd 
t ! relation%ip betwe5 race &           
recon/ruction rates p]si/$ :5           
demographic & cl9ical factors 7         
controll$ =4 ,m9ority wom5 are          
significantly less likely ?an           
,caucasians to see a pla/ic surgeon be=e
 initial surg]y1 7 mo/ likely to desire 
m in=mation ab\t recon/ruction1 &       
satisfaction 0 l[e/ among m9ority wom5  
)\t recon/ruction4  7#ac7 ,! l[ use (   
recon/ruction = m9orities is n expla9$  
by l[] dem& = ! proc$ure4 ,l[] heal?    
lit]acy1 f9ancial issues1 & less access 
to pla/ic surgeons em]g$ z b>ri]s to    

recon/ruction 9 ! #bjji ,ald]man /udy4  
,^! results sugge/ t !re is a sub/antial
 unmet ne$ = in=mation1 especially among
 racial & e?nic m9ority gr\ps reg>d+    
recon/ruction options & cov]age requir$ 
by ! ,wom5's ,heal? & ,canc] ,rights    
,act ( #aiih4  7#ad7 ,a #bjaj /udy by   
,w>r5 ,h4 ,ts5g1 ,m4,d4 & o!rs at !     
,univ]sity ( ,cali=nia ,davis f\nd t    
pati5ts f rural areas are less likely to
 und]go brea/ recon/ruction foll[+      
ma/ectomy = brea/ canc] ?an _! urban    
c\nt]p>ts4  #c4 ,brea/ recon/ruction    
education ,"p ,v ( title ,,iii ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bhjm2 programs relat+ to     
brea/ heal? & canc]7 is am5d$ by add+ at
 ! end ! foll[+3  #cii,,nn-#a4 ,brea/   
recon/ruction education  7a7 ,9 g5]al ,!
 ,secret>y %all provide = ! plann+ &    
implem5tation ( an education campaign to
 in=m brea/ canc] pati5ts anticipat+    
surg]y reg>d+ ! availability & cov]age (
 brea/ recon/ruction1 pro/heses1 & o!r  
options1 ) a focus on in=m+ pati5ts :o  

are memb]s ( racial & e?nic m9ority     
gr\ps4  7b7 ,in=mation ,to ,be          
dissem9at$  7#a7 ,specific in=mation    
,su* campaign %all include dissem9ation 
( ! foll[+ in=mation3  7,a7 ,brea/      
recon/ruction is possible at ! "t (     
brea/ canc] surg]y1 or at a lat] "t4    
7,b7 ,pro/heses or brea/ =ms may be     
available4  7,c7 ,f$]al law m&ates bo?  
public & private heal? plans to include 
cov]age ( brea/ recon/ruction &         
pro/heses4  7,d7 ,! pati5t has a "r to  
*oose a provid] ( recon/ructive c>e1    
includ+ ! pot5tial transf] ( c>e to a   
surgeon t provides brea/ recon/ructive  
c>e4  7,e7 ,! pati5t may opt to und]go  
brea/ recon/ruction "s "t aft] ! "t (   
brea/ canc] surg]y = p]sonal or m$ical  
reasons1 dur+ treatm5t or aft]          
completion ( all o!r brea/ canc]        
treatm5ts4  7#b7 ,o!r in=mation ,9      
addition to ! in=mation describ$ 9      
p>agraph 7#a71 su* campaign may include 
dissem9ation ( su* o!r in=mation 7:e!r  
develop$ by ! ,secret>y or by o!r       

entities7 z ! ,secret>y det]m9es        
relevant4  7#c7 ,requir$ publication ,! 
in=mation requir$ to be dissem9at$ "u   
p>agraph 7#a7 & any in=mation dissem9at$
 9 accordance ) p>agraph 7#b7 %all be   
po/$ on ! ,int]net ,web sites ( relevant
 ,f$]al ag5cies1 includ+ ! ,(fice (     
,wom5's ,heal?1 ! ,(fice ( ,m9ority     
,heal?1 & ! ,(fice ( ,rural ,heal?      
,policy4  7#d7 ,re/riction ,su* campaign
 %all n specify1 or be design$ to s]ve z
 a tool to limit1 ! heal? c>e provid]s  
available to pati5ts4  7c7 ,consultation
 ,9 develop+ ! in=mation to be          
dissem9at$ "u ?is section1 ! ,secret>y  
%all consult ) appropriate m$ical       
societies & pati5t advocates relat$ to  
brea/ canc]1 brea/ recon/ructive surg]y1
 brea/ pro/heses1 & brea/ =ms & ) pati5t
 advocates repres5t+ racial & e?nic     
m9ority gr\ps ) a special emphasis on   
,african-,am]ican & ,hispanic           
populations4  7d7 ,def9itions ,9 ?is    
section1 ! t]ms racial & e?nic m9ority  
gr\p & ,hispanic h ! mean+s giv5 su*    

t]ms 9 section #agjg4  7e7 ,report ,n   
lat] ?an #b ye>s aft] date ( enactm5t ( 
! ,brea/ ,canc] ,pati5t ,education ,act 
( #bjac & e #b ye>s !reaft]1 ! ,secret>y
 %all submit to ! ,committee on ,heal?1 
,education1 ,labor1 & ,p5sions ( !      
,s5ate & ! ,committee on ,en]gy &       
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report describ+ ! activities c>ri$ out  
"u ?is section dur+ ! prec$+ #b fiscal  
ye>s1 :i* %all include an evaluation ( !
 ext5t to :i* su* activities h be5      
effective 9 improv+ ! heal? & well-be+ (
 racial & e?nic m9ority gr\ps4  4