Our new report, Rebuilding my body: Breast reconstruction in England, launched today reveals breast reconstruction for breast cancer patients is being restricted in some areas of England.
Breast Cancer Now has uncovered new evidence that 47 local health bodies (22.6%) - called Clinical Commissioning Groups (CCGs) - are formally restricting breast reconstruction surgery.
We found that CCGs restrictions included:
- Limiting the number of surgeries a breast cancer patient can have to complete their reconstruction
- Introducing a time limit in which breast reconstruction must be complete
- Denying access to balancing surgery on the unaffected breast
Naturally we are worried about these findings, which follow a report from the APPG on Breast Cancer (opens as PDF) that highlighted other regional variations in breast cancer services.
Breast reconstruction for breast cancer patients is not cosmetic surgery. For some women it is a chance for women to return to normality and rebuild their self-esteem, body image and sexuality after breast cancer treatment.
Over a decade ago, The National Mastectomy and Breast Reconstruction Audit collected details of women who underwent mastectomy and breast reconstruction. The audit found that when asked how often they felt sexually attractive when undressed, 15% of women who had a mastectomy without reconstruction answered most or all the time, compared to 47% of those who had immediate or delayed breast reconstruction. Breast reconstruction can be key for some women to live well after a diagnosis of breast cancer.
Victoria, a primary breast cancer patient from London, had a very positive experience of breast reconstruction. She explained:
I was diagnosed with stage 1 breast cancer in 2014 - it was a total shock to the system. I met with my surgeon a week after I was diagnosed, and knew at that point I wanted a double mastectomy and reconstruction as I believed it would reduce the risk of my cancer returning.
Luckily he respected my wishes, and didn’t try to talk me out of anything. I had six rounds of chemotherapy beforehand, then my surgery in February 2015 - I went for implants with bio-tissue mesh.
I had the best possible care I could’ve imagined. My surgeon left my nipples intact and the sensation in my breasts has even come back. I go swimming with my girls, wear a bikini and feel I have nothing to hide. I’m so happy with how I look- I feel like a woman again.”
What can be done?
We are calling for an end to these restrictions. We want each Clinical Commissioning Group (CCG) to adopt new guidelines, which state that the full range of breast reconstruction options should be available to all patients, including balancing surgery on the unaffected breast. Patients should be able to delay their breast reconstruction surgery for as long as they need following treatment.
We also want the Health Secretary, Matt Hancock, to order an up-to-date breast reconstruction audit, so we can get a better picture of what’s happening and identify any areas of the country where unnecessary restrictions are preventing women from living well after breast cancer.