Breast reconstruction after cancer (2018)

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  • Status: Closed
  • During the summer of 2017, we carried out consultation on a proposal to introduce a policy covering breast reconstruction surgery after cancer.

    This proposal covered reconstruction on the affected breast but did not cover the unaffected breast

    Following feedback from the public, patients and stakeholders and further advice and guidance from clinicians and NHS England, we have amended the original proposal.

    We are now consulting on an amended proposal that covers surgery on both the affected and unaffected breast.

    The aim of this policy is to ensure that breast cancer patients have access to high quality and appropriate rebalancing surgery, based on the principle of “right care, first time”.

    The policy is to be used by clinicians as a tool to support clinical discussions.

    Who does this policy affect?

    • The policy applies to all people diagnosed with breast cancer on or after the date of the policy being introduced.
    • Patients with a breast cancer diagnosis prior to the date of the policy being introduced are to be treated in line with the spirit of this policy which is considered to be the best practice approach to breast reconstruction following cancer.
    • The policy applies to men and women and has no upper or lower age limits.

    What are the timescales involved?

    • Breast reconstruction of the affected breast and rebalancing of the unaffected breast will be available for patients who have completed treatment for cancer which resulted in the removal of breast tissue within the last five years. This will only apply to patients diagnosed from the date of this policy being adopted. Patients treated before the adoption of this policy will not be restricted to this timescale. 
    • This timescale is extended to seven years for those who have had inflammatory breast cancer.
    • The timescale between the first and third surgery must fall within two years. The two year timescale will start from the date of the first of the reconstruction and/or balancing procedures.

    How many surgical procedures are allowed?

    • Patients who elect to have reconstruction and/or rebalancing surgery will be able to have up to three surgical procedures.
    • A surgical procedure is any surgery performed under general anaesthetic

    Who makes the decision to approve surgery?

    • Any decision to treat the affected or unaffected breast must be approved by a multidisciplinary team to ensure it is clinically appropriate.

    What happens if the decision is no?

    • Where a patient does not meet the published criteria, an application for funding may be submitted by the clinician if they view the patient’s circumstances are clinically exceptional compared to all other patients who also do not meet the published criteria

    What doesn’t the policy cover?

    • This policy does not include cosmetic surgery for patients who have completed breast reconstruction and/or rebalancing treatment

    An easy to use flow chart explaining the policy is available in the proposals summary document below.

    NHS proposals January 2018: summary document

    We welcome your views on the proposals outlined in this document.

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