I n 1996, an estimated 182,000 women will be diagnosed with breast cancer, making it the most common form of cancer among women in the United States. Statistics show a woman’s lifetime risk of contracting breast cancer, if she lives to be 85, is one out of nine, or 11% of our population. It is estimated that 46,000 women will die of breast cancer in 1996, making it the second major cause of death among women after lung cancer. Recent advances in breast cancer management have allowed most women to be treated with the breast-conserving technique of lumpectomy followed by radiation. However, a significant percentage of women with breast cancer must undergo mastectomy, or amputation, of their breasts to treat their disease most appropriately. Some women adapt well to the breast amputation, but some feel desperately mutilated. It is not a question of age or beauty, as many older women are more devastated by the loss of a breast than a younger woman. Because of its role as a secondary sexual organ, the breast plays an important role in the self-image of women. For many women, therefore, the loss of a breast as a result of cancer can also mean a loss of part of their sexual identity. For these women, breast reconstruction is extretnely itnportant to restore their sense of wholeness and well-being. In 1993, 2 years after I started my plastic surgery practice, a 34-year-old woman came to me as a patient requesting bilateral breast reconstruction following her bilateral mastectomies. The insurance company denied payment for the procedure, stating that it was not medically necessary. Soon afterward, another patient was denied coverage for breast reconstruction. This time the insurance company justified the denial by contending there was no reason to restore an organ that has no function. At this point I felt that something needed to be done. Insurance companies will pay for reconstruction of other body parts, such as an ear, nose, hip, or a knee after an accident or cancer surgery. The breast is the only body part that is subjected to this discrimination. I therefore began looking into the possibility of passing federal legislation to guarantee that women can receive insurance coverage for breast reconstruction. After the Federal Health Care Reform Plan failed in 1995, however, it became evident that