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DIEP backlog: Mission impossible?
Haneen Abed1, Joanna Skillman1
1Department of Plastic Surgery, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK.
Insights
The COVID-19 pandemic significantly impacted breast cancer care, leading to long waiting lists for autologous breast reconstruction. Over 2255 patients face a 2-year backlog, with 40 developing cancer while waiting.
Area of Science:
- Oncology
- Plastic Surgery
- Public Health
Background:
- The COVID-19 pandemic disrupted healthcare services globally, particularly elective surgeries.
- Access to autologous breast reconstruction for breast cancer patients has not fully recovered post-pandemic.
Purpose of the Study:
- To quantify the current waiting list backlog for autologous breast reconstruction.
- To assess the impact of the pandemic on reconstruction service provision.
Main Methods:
- A questionnaire was distributed to 31 surgical units.
- Data on patient waiting lists for autologous breast reconstruction were collected.
Main Results:
- A minimum of 2255 patients are currently on waiting lists.
- The existing provision indicates a 2-year and 5-month backlog.
- 40 women developed breast cancer while awaiting reconstruction.
Conclusions:
- The pandemic has exacerbated national inequities in breast reconstruction access.
- Urgent recommendations include expanding surgical capacity and optimizing plastic surgeon resources.
- Increased training for autologous reconstruction is crucial to address the backlog.
Abstract:
The outbreak of the coronavirus disease 2019 (COVID-19) pandemic caused global challenges, including the restriction of surgical options for women with breast cancer. Autologous reconstruction availability has still not returned to pre-COVID-19 levels. This study aimed to collect data about waiting lists for autologous breast reconstruction and is the first of its kind. A total of 31 units were approached and asked to complete a study specific questionnaire. In total, there are at least 2255 patients on a waiting list, which equates to a 2-year and 5-month backlog at the current level of provision, without the inclusion of new referrals. Alarmingly, 40 women reportedly developed breast cancer whilst on the waiting list. The impact of COVID-19 has been significant, revealing national inequity in reconstruction provision and long waiting lists. Recommendations include increasing theatre capacity, optimising plastic surgeons' job plans to prevent waiting lists from growing as well as training more surgeons in autologous reconstruction.
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