More than 1,500 NHS breast reconstructions delayed due to Covid
More than 1,500 breast cancer patients in UK face long waits to have reconstructive surgery after hospitals could not operate on them during the pandemic because they were tackling Covid-19.
The women are facing delays of “many months, possibly years” because the NHS has such a big backlog of cases to get through, according to research by the charity Breast Cancer Now.
When the lockdown began in March the NHS stopped performing breast reconstructions for women seeking one after a mastectomy as part of its wider suspension of care. That was because so many operating theatres were being used as overflow intensive care units and because doctors and hospital bosses feared that patients coming into hospital might catch Covid.
The NHS started doing them again in July, but not everywhere and not in the same numbers as before.
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Women already faced delays in accessing reconstructive surgery in many parts of the UK before the pandemic struck, and there is concern that those who want to have the operation will have to wait until hospitals can again routinely offer the service, which may not be until 2021 or later.
“We are deeply concerned by our finding that over 1,500 breast cancer patients may now face lengthy and extremely upsetting delays for reconstructive surgery,” said Delyth Morgan, the chief executive of Breast Cancer Now. “This will leave many women who want to have reconstruction with one breast, no breasts or asymmetric breasts for months, possibly even years.”
About 55,000 women a year are diagnosed with breast cancer, which is the most common type of female cancer. About 30% of the 14,850 a year who have a mastectomy choose to undergo reconstructive breast surgery, immediately or later.
Lady Morgan said: “Reconstructive surgery is an essential part of recovery after breast cancer for those who choose it.
“Women with breast cancer have told us these delays are causing them huge anxiety, low self-esteem and damaged body confidence, and all at a time when the Covid-19 pandemic has denied them access to face to face support from healthcare professionals and charities.”
She welcomed the resumption of reconstructive surgery, but said: “Until operations are fully resumed the Covid-19 backlog will only continue to grow, worsening already lengthy waiting lists.”
Covid-related disruption in hospitals meant that most surgical units that carried out breast reconstruction could only do 20-50% of their normal caseload, said Ruth Waters, the president-elect of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (Bapras). Access to operating theatres for such operations “remains very restricted”, she added.
Nadine Thomas, a deputy headteacher in Wales, had a mastectomy in April after a recurrence of the breast cancer she had first been diagnosed with in 2013, and has a prosthetic right breast.
“At that point there was no discussion of a reconstruction at all, that option was taken off the table. So while I’ve now had the mastectomy and the cancer has gone, which I am so grateful for, I couldn’t have reconstruction at the same time,” said Thomas, 52.
She wants to have the reconstruction to improve the appearance of her chest, especially scarring from the mastectomy and some “lumps and bumps”. She said: “What I’ve got is a 3D body. I’m quite surprised about how distorted my body is after the surgery,” she said.
“I feel I’ve had wonderful care from everyone in the NHS. But I have been told that it could be two years before I have the reconstruction, especially as I have to lose some weight before I can be referred. I feel uneasy about waiting so long. Will it be 2021 or 2022?”
Breast Cancer Now’s estimate that at least 1,500 women had been unable to have the procedure between March and June is based on the number who usually do every four months, according to the National Mastectomy and Breast Reconstruction Audit.
Dr Julie Doughty, the president of the Association of Breast Surgery, said: “This has been a very difficult and worrying time for patients with breast cancer. Since the start of Covid the majority of women with breast cancer have been treated. However, breast reconstruction was halted during the peak of the coronavirus outbreak.”
A spokesperson for the NHS in England said: “These are very personal decisions for women with breast cancer, but reconstruction surgery is available on the NHS, and should be provided as soon as practically and safely possible, while local services should not place a time limit on women’s access.”
