European Society of Plastic, Reconstructive and Aesthetic Surgery Calls for Official Guidelines on Breast Reconstruction

In In The News by Barbara Jacoby

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SOURCE: European Society of Plastic, Reconstructive and Aesthetic Surgery


The lifetime risk of breast cancer is 1/7, the most common female cancer. While curable in 70–80% of patients, treatment (including surgery, radio- and chemotherapy) often leave women physically and psychologically impaired. Breast reconstruction plays an invaluable role in recovery, increasing patients’ self-esteem and quality of life.

The European Society of Plastic, Reconstructive and Aesthetic Surgery; the umbrella organisation of European national societies which has over 7,000 members; published the results of a ground-breaking survey about breast reconstruction across the Continent. The findings highlight a clear need for an international, evidence-based standard for best practice.

The study – completed over two months by representatives of 29 countries – addressed: Structure/Access of Care; Immediate/Delayed Procedures; Symmetrizing; Radiation Therapy and Guidelines.

According to ESPRAS President Rado Zic;

“The aim was to survey the current trends and regional differences in the delivery of breast reconstruction, to initiate policy development and identify areas requiring research – ultimately resulting in evidence-based guidelines leading to a more equitable provision across Europe.”

Key findings:

  • Incidence of reconstruction after mastectomy is generally low across Europe, and controversy still exists regarding the most appropriate techniques
  • Plastic surgeons are involved early on in the mastectomy process only in a minority of countries. Reconstruction was also performed by other specialties, e.g., gynaecologists
  • In most countries, preventative mastectomy is offered to high risk patients
  • Rates of procedures to make both breasts symmetric were high, although 1/5 were not offered this option
  • Responses varied greatly regarding the optimal timing for reconstruction in irradiated patients (immediate or delayed). There was a clear lack of evidence regarding this topic
  • Only 45% of respondents reported the existence of national guidelines. Official recommendations regarding techniques were available in only 32%
  • Almost all respondents would value European guidelines and requirements for best practice. There was great interest in multi-center studies and the launch of2 a task force

Rado Zic concludes;

“This study identifies a lack of coherence in international practice and strong demand for European guidance. What is clear is that there is a need for plastic surgeons to be included in the decision-making from the start of the process, as our profession has the broadest oncological and reconstructive expertise to achieve a uniquely tailored outcome for women who have suffered with breast cancer.”

Countries participating include: Austria, Azerbaijan, Belgium, Bosnia and Herzegovina, Croatia, Cyprus, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Montenegro, Netherlands, Norway, North Macedonia, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, UK.