New Project! Amend the NAPBC’s Reconstructive Protocol

Women going flat after mastectomy are not getting the care we need and deserve, in part because most of us cannot access a plastic surgeon for our closure. Women reconstructing their chest wall should be able to access a specialist just like women who are reconstructing their breasts. That’s why we want the American College of Surgeons to amend the NAPBC’s reconstructive consult protocol to include flat closure. 

The National Accreditation Program for Breast Centers (NAPBC), run by the American College of Surgeons, is a program that safeguards patient care by certifying breast centers according to strict quality criteria. One of these criteria is the reconstructive consult protocol, which delineates what must be covered in a plastics consult for patients facing mastectomy. The current version of NAPBC’s reconstructive consult protocol only requires plastic surgeons to discuss breast mound reconstruction options (implants, flaps). The option of aesthetic flat closure is missing entirely.

This protocol, while well intentioned and certainly helpful to women who choose to reconstruct their breasts, has unfortunately had the unintended effect of reinforcing this myth that women going flat don’t care how we look. The protocol formally embodies the status quo: breast mound reconstruction deserves an aesthetic specialist, and flat closure does not. This is why, along with legislative action and improved reimbursement, we are targeting this protocol for amendment. It’s quite simple: we would like to see flat closure added as a fourth line item in Standard 2.1.8:

It’s time to improve the standard of care for patients going flat. The NAPBC can help facilitate this by adopting an amendment to their reconstructive protocol along the lines of what we have proposed here. We look forward to seeing NAPBC representatives at the upcoming conference in April!