Study will set worldwide standards

PUBLISHED: 08:38 18 March 2008 | UPDATED: 10:39 03 July 2010

A Norfolk surgeon spearheading a national study of mastectomy and breast reconstruction practices has told how the findings would help set standards across the world.

A Norfolk surgeon spearheading a national study of mastectomy and breast reconstruction practices has told how the findings would help set standards across the world.

Jerome Pereira, who was a pioneer for the East of England when he began offering reconstruction at the time of mastectomy at Gorleston's James Paget Hospital in 1997, said he hoped the four-year audit would massively raise women's awareness of the possibility and potential of immediate breast reconstruction.

And in the wake of the study's first findings - given national prominence earlier this month - that only one in 10 patients with breast cancer are currently getting access to reconstruction at the time of mastectomy, he said he hoped his work would help to end the postcode lottery.

Despite recommendations from the National Institute for Health and Clinical Excellence in 2002 that it should be available to all patients, the study has found that more than 25pc of hospitals nationally do not even offer immediate reconstruction.

Mr Pereira said: “It is not suitable for all patients, for example if they have advanced cancer, and some will still choose not to take it up, but increasing public awareness will put women in a position to make an informed decision.

“We are looking at life after breast cancer and the message we want to send out is that you don't have to live life in mutilation.”

The JPH already offers immediate reconstruction to 20pc of patients - twice the national average and a similar proportion to the Norfolk and Norwich University Hospital - but Mr Pereira is keen to see that rise even further and highlighted some units where they had already achieved a figure of one in three.

Thousands of patients nationally will be interviewed in the audit - being carried out for the Healthcare Commission - before it comes to an end in 2010.

The study will focus on access to breast reconstruction, the quality of information given to patients to help them make decisions on types of operation and surgical outcomes and satisfaction rates.

Mr Pereira said no such study had ever been done before anywhere in the world and it would help to establish new standards of care.

Its importance was shown by the fact that as many as 40,000 breast cancer patients were diagnosed each year and one third of those underwent mastectomies.

He added that the number of women undergoing breast cancer operations in the past decade had increased by one-third.

Patient Valerie Streames, 63, of Geldeston, near Beccles, who underwent immediate breast reconstruction at the JPH eight years ago, endorsed Mr Pereira's campaign to make it more accessible.

She said: “It is a shock when you are told you have cancer and to be able to come into hospital with two breasts and go out with two breasts is psychologically brilliant. We all want to be normal and yet when you are diagnosed you feel very much different from other women.”

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