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.”
- 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.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.