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Breast cancer reconstruction 'still a lottery'
Anna Davis25 Sep 2008
Breast cancer patients face a postcode lottery over the standard of surgery they receive, a leading doctor claimed today.
Many women are not offered the "gold standard" reconstruction surgery after their cancer operations and are left with imperfect breasts, consultant plastic, reconstructive and cosmetic surgeon Charles Nduka warned.
As he launched a campaign to educate women about the most advanced operations they should be demanding, he said: "Women should not feel guilty about asking for the best. I have seen so many women who have had sub-optimal results. They ended up with relationship issues, body image issues, anxiety and depression."
Mr Nduka, who first noticed the problem while working at the Royal Marsden hospital, added: "Women considering breast reconstruction following breast cancer are often not given the full range of options available in what can sometimes be a postcode lottery and may end up choosing an option that isn't right for them or which requires further plastic surgery."
Some women who are given normal breast implants after surgery suffer from "capsular contracture" where the skin around the implant hardens. They can look less natural over time as the breast droops with age but the implant does not.
One of the most advanced techniques available avoids these problems by using tissue from the woman's lower abdomen to rebuild the breast. The operation, known as a DIEP flap, incorporates a tummy tuck, so patients wake up with a f lat stomach as well as reconstructed breasts. It can be carried out as part of the mastectomy operation.
Mr Nduka said: "This technique leaves women with natural feeling and looking results. The patient can then forget about their breast cancer. The latest technique has been around for about eight years but there is a great disparity in the number of patients offered it."
Mr Nduka, who now works at the Queen Victoria Hospital in West Sussex, has created a DVD to be given to breast cancer patients outlining the operations available.
He said: "Women just don't know about this technique and I want to empower women to ask for it. It is usually available in hospitals where plastic surgeons work closely with breast cancer surgeons. But patients can choose which hospital they go to. If your local hospital cannot offer you the treatment that is best for you, you can be referred elsewhere."
In London the DIEP flap operation is carried out at the Royal Marsden, St George's, Charing Cross and Royal Free hospitals as well as Barts & the London and Guy's & St Thomas' NHS Trusts. www.breastreconstructionfor life.org.uk.
'MY STOMACH TISSUE WAS USED INSTEAD OF IMPLANT'
CHARLES NDUKA performed surgery on mother-of-three Tara Chalmers after she had breast cancer which was diagnosed in 2004.
The 39-year-old account manager from Worthing said: "I was told I could have implants or this new operation where skin would be taken from my stomach.
"I decided that was the way to go because I felt it would be part of me, rather than having something foreign inside me.
"I had to put on weight so there was enough flesh on my stomach to be used. Mr Nduka told me to eat some doughnuts!
"I am so pleased with the results, also my stomach is really flat now. I think the DVD is a great idea, women should be aware of what is out there."
