Delivering real choice in reconstruction

 

This week we launched our report Delivering real choice: the future of breast reconstruction in England.  

For those who choose it, breast reconstruction is a vital part of recovery from breast cancer or from risk-reducing surgery. So people must be able to access the right type of reconstruction, at the right time for them. However, too often, this access and choice is being denied.  

To understand more about people’s experience of breast reconstruction we have been undertaking research to better understand the current picture.  

What work have you done in this area? 

We’ve: 

• Conducted a UK-wide online survey of 2,586 people affected by breast cancer who had received or were awaiting breast surgery, including risk-reducing surgery and breast reconstruction. We also conducted six in-depth interviews with people with breast cancer to understand more about their experiences. 
• Sent Freedom of Information requests to hospital trusts across England on local restrictions on reconstruction services and the impact of the COVID 19 pandemic.  
• Hosted a summit in April with healthcare professionalsto discuss the key issues affecting breast reconstruction services and to explore potential solutions. 
• Analysed Hospital Episode Statistics data to assess the breast reconstruction activity undertaken before and during COVID 19.  

What did you find out? 

We identified the barriers and challenges facing breast reconstruction services and patients include: 

A lack of information and support in making a decision about reconstruction. Only 53% of women surveyed that had or were waiting for breast reconstruction ‘definitely’ felt they were offered the full range of reconstruction options and 19% felt they were unable to access support as part of decision making.   

• Limited capacity for, and barriers to accessing, free flap reconstruction which suggests that many women may be opting for surgeries they wouldn’t otherwise have chosen or are putting up with significant delays.   
• Backlogs exacerbated by the COVID-19 pandemic. Data shows there was a drop in breast reconstruction activity of 64% in 2020/21 and 34% in 2021/22 compared to 2018/19.  
• Some remaining local restrictions that limit the timeframe in which women can have reconstruction, or the number of surgeries they can have, highlighted by our FOI request. 

What is Breast Cancer Now asking for? 

We are calling on NHS England to work in partnership with us, the Association of Breast Surgery (ABS) and the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) to develop a practical plan for breast reconstruction services that addresses the backlog, removes barriers and ensures timely and fair access to reconstruction for all women who want it. 

Our report makes a number of recommendations to help achieve this. These include eliminating long waits by ensuring breast reconstruction is incorporated within the Referral to Treatment target, increasing capacity to deliver free flap reconstruction and ensuring service structures enable access to it. Alongside this, we’re calling for all local restrictions on access to breast reconstruction to be removed. 

How can I get involved? 

We want to amplify the voices of those affected and start a conversation on the importance of being able to access the right type of reconstruction, at the right time. So, if you are considering, waiting for, or have had breast reconstruction and feel comfortable sharing your experiences, please join the conversation on: 

• Twitter – using the hashtag #DeliveringRealChoice and tagging @BreastCancerNow in your post 
• Facebook – by commenting on our post 

Or you can tell us your story to help us raise awareness in the future 

If you have a query about breast reconstruction, you want to talk things through or find more support, our breast care nurses are here for you. Just call our free Helpline on 0808 800 6000. 

Our nurses are hosting a Facebook Live session on breast reconstruction on our Breast Cancer Now Facebook page at 7pm on Thursday 20 October. After the event you can watch the session here.