Surgeon warns that hospitals need to face the resource implications of breast reconstructi...( nd mastectomy plus expander groups and...),Health

nd mastectomy plus expander groups, and five in the TRAM group. The average number of out-patient appointments was 1.6 (mastectomy), 4.5 (expander) and 3.7 (TRAM). No one in the mastectomy group had further surgery, whereas 70% of the expander group and 50% of the TRAM group did.

There are a number of reasons why patients undergoing breast reconstruction need more out-patient appointments and further surgery. Infection, bleeding or compromise of the blood flow to the newly formed breast are all potential problems. Further surgery might be required to perform nipple reconstruction and to make minor adjustments to the shape of the reconstructed breast.

Mr Dace said: We have demonstrated that simple cancer surgery such as mastectomy and axillary node clearance is much less time-consuming than when it is followed immediately by a reconstructive operation. Thus, in the time to do a mastectomy and reconstruction, in some cases up to three simple mastectomies without reconstruction could be performed. We are not suggesting that reconstruction should not be done, but extra resources should be made available and the extra requirements should be acknowledged when busy breast units offer a full reconstructive service.

This is a pilot study and we are aware that the numbers of patients are small and therefore the conclusions reached must be taken in the context of this fact. However, a further audit of larger groups is being performed and this should give a clearer idea of the issues raised.

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Contact: Emma Mason
wordmason@aol.com
44-7711-296-986
Federation of European Cancer Societies
21-Mar-2002

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