Only one in 10 women with breast cancer is getting access to reconstruction surgery at the time of their mastectomy, despite recommendations from the National Institute for health and Clinical Excellence (NICE) in 2002 that it should be available to all. These are the early findings of the National Mastectomy and Breast Reconstruction Audit, published today by the Royal College of Surgeons of England and the NHS Information Centre on behalf of the Healthcare Commission.
The number of women diagnosed with breast cancer has risen steadily in recent years. As a result there was a 37% increase in the total number of operations performed for breast cancer in the NHS in England between 1997 (24,684) and 2006 (33,814). While this expansion in capacity shows a remarkable flexibility on the part of the NHS there are a number of problems with breast cancer surgery services that remain to be addressed.
Other findings include:
The number of English NHS Trusts carrying out breast conserving and mastectomy surgery has fallen by 27 per cent since 1997 as a result of the centralisation of services designed to improve the quality of care. This should be regarded as a good thing, particularly for difficult and complex cancer surgery.
A fifth of English NHS Trusts that perform breast cancer surgery do not employ a consultant radiologist, pathologist or oncologist specialising in breast cancer diagnosis or treatment.
The National Audit, the first of its kind in the world, describes the initial findings of a four year comprehensive study of mastectomy and breast reconstruction practices and outcomes in England and is due for completion in December in 2010. Future annual reports will gather new data on patient experience and outcome to gain a full picture of how NHS services for breast cancer are working.
The first annual report and more detail about the audit is available at www.ic.nhs.uk/mbr
"No. I am not surprised. The price of reconstructive surgery is not always something the patient can afford. My down payment was requested at $2500 with another $2300 to follow. That is not do - able on our income. So no reconstructive surgery for me!" - Name and address supplied