(First of all, apologies to the mods for making a new username, but many EF members know me in real life and know my normal username. I'd rather ask these questions with some anonymity.)
I have searched the forum and have found little info on mastectomy surgery in CH. There is a host of general information available online from various sources around the world, but standard practices seem to vary enormously by country, and I'd like to know what is typical in Switzerland, including what might/might not be covered by basic insurance. Plus, even if I can find out some of this info directly from my insurance, I still think it could be useful to have a thread containing mastectomy-related info on EF to be available to everyone.
I have previously had breast cancer in 2019-2020, and had a lumpectomy which was not considered satisfactory. Two months later I had a much more major removal of breast tissue, accompanied by a reduction of the non-cancerous breast to keep things symmetric. I stayed in the hospital for a week, was off work for >1 month, and eventually had 5 weeks of radiation therapy. Am currently taking hormone therapy (tamoxifen).
I have now been diagnosed with cancer in the other breast, and have been told I need a mastectomy. I am actually not surprised by this news, as I was having unexplained pain and swelling for many months.
My questions are:
1. Given that I want to still have things on my chest that are shaped like breasts after all this is over, what are the typical reconstruction procedures in CH? From what I have read online, in some countries they prefer to reconstruct using tissue from other parts of your body (thigh/stomach/back), whereas in the US the use of implants is not uncommon. My initial thought is that I would prefer to go the implant route as I really don't fancy having muscle cut out of my back, but has anyone out there in EF-land had one or the other and would be able to comment? I only have basic insurance, I am not sure what procedures might be covered as cancer-related vs. considered cosmetic.
2. Given that I am young and have already had cancer happen independently in each breast, I am kind of thinking maybe I should just have them both chopped off and be done with it. Does anyone know if an elective mastectomy+ reconstruction of my non-cancerous breast would be covered by insurance?
Thanks in advance...
Honestly this is a very serious thing, so I'd advice to:
- consult your doctor about those
AND
- all your insurer and check with them directly
Nobody here will give you better advice than combination of those two.
Best of luck!
I can't thank you yet Jaceq, but thanks for your positive response. I know I can find out lots of this info from my insurance, but I would actually like to have a thread about this on EF as well so people can share their experiences, and this thread can also serve as a reference for people who might have to deal with this in the future.
I‘m sorry I can‘t answer your questions from experience, although I was diagnosed with and treated for breast cancer in 2010-2011. I’m sorry yours has returned .... Cancer sucks.
I was post menopausal, had a lumpectomy and no recon, and so don’t know about the surgery or insurance issues.
Although you absolutely need medical and insurance info, sometimes peer support is really helpful.
Please check out the ESCA (English speaking cancer association) - online at
cancersupport.ch -
They are located in Geneva, and have lots of experience and helpful advice. They might also have a good referral network if you need that. I also expect some of their volunteers have more local experience with insurers, coverage and facilities.
You might also check with the cancer league - in German it’s Krebsliga.ch (you can switch language across the top and select French, and also regional groups. )
I hope everything goes well with your treatment and perhaps these resources can help.
That's really shitty news and i cannot add anything to help, sorry.
Switzerland is fairly good for medical issues, even with just basic insurance, can you maybe get couple of opinions from different doctors ?
Hello -- I am a breast cancer nurse in Geneva. I am sorry to hear about your situation. How old are you? Do you have other risk factors for breast cancer (family history of cancers, age younger than 51 at diagnosis, Ashkenazi Jewish ethnicity, among others)? A contralateral breast cancer diagnosis is a major risk factor for onco-genetic mutations, and a genetic consultation may be recommended. If so, your insurance will generally cover this test (normally about CHF 4000). And if you have a genetic mutation such as BRCA1 or BRCA2, a preventative mastectomy (as well as removal of ovaries due to increased risk of ovarian cancer) would generally also be covered by your insurance. There are other mutations which increase your risk, but insurance tries to argue against covering a mastectomy. It's important to be treated in a certified breast center with a multidisciplinary team of specialists who will work hard to ensure you receive the appropriate care and have appropriate reimbursement from your insurance.
On the other hand if you do not have a genetic mutation, a mastectomy may not be covered by your insurance. However depending on the tumor's characteristics (especially the size and location in the breast, and how that relates to the new shape and size of your breasts since your last surgery), a mastectomy with reconstruction may be the best treatment in your case. And for that, it would be covered by your insurance. We're talking about basic insurance. Implants (AKA prostheses) are the standard of care in my clinic, but we certainly offer the flaps/DIEPs/Lambeaux alternatives when needed.
And I second the suggestion to seek the support of ESCA CancerSupport -- they are an amazing group.
Hope this helps! Happy to provide additional information if needed.
Hi there, thanks ever so much for your informative response, I'll definitely PM you with a few questions, but I'll summarize them here as well:
1. My clinic of reference is CHUV, the cantonal university hospital where I was operated twice in the past. I do not know if they would agree to an elective mastectomy on the non-cancerous breast (where I did in fact previously have cancer). I also don't know if they do implants vs. reconstruction. I would be willing to pay out-of-pocket for implants, but don't know if they would even agree to do this type of surgery. I will contact my referent breast cancer nurse at the hospital to ask these questions. I would not be surprised if they only do what is medically advised, and an optional mastectomy + implants might not be possible at CHUV.
2. I also need to contact my insurance to see what is covered: I have already had genetic screening done and don't have any mutations of significance, but am very young (born in the 80's!) and given my history of cancer in each breast I'm 98% sure I want a double mastectomy. I hope the doctors will agree to this as well and medically advise me to have both breasts removed.
3. I know there are specialized private clinics where I could have everything done, but I only have basic insurance, and do not fit into the category of rich expat banker who considers a salary of 120k a year borderline poverty. I want the best treatment available, but finances are a big constraint. I think I will insist on a double mastectomy no matter what, and then reconstruction vs. implants will be largely a question of finances.