The development of a rural breast reconstruction service: patient reported outcomes and benefits.

BACKGROUND: In 2021, breast cancer was one of the most commonly diagnosed cancer in Australia (Health AIo, Welfare. Cancer in Australia 2021. Canberra: AIHW, 2021). While a mastectomy remains a treatment of choice, only a small percentage of women have access to a breast reconstruction after (Group AAtBRC. Position statement on access to post-mastectomy breast reconstruction information and services in Australia, 2021). Women living in a rural area are less likely to have a breast reconstruction; compared to their metropolitan counterparts (Bhat D, Heiman AJ, Talwar AA, Dunne M, Amanjee K, Ricci JA. Access to breast cancer treatment and reconstruction in rural populations: do women have a choice? J. Surg. Res. 2020; 254:223-31). This study analyses the impact of single breast reconstruction service on a Modified Monash 3 (MM3) region and informs consumers and providers of the importance of a breast reconstruction unit embedded in a rural health network.

METHODS: Following ethics approval, all 64 patients who had undergone a breast reconstruction with this service between 2017 and 2021 were contacted. Patient reported outcomes were recorded through phone interviews, using a standardized questionnaire. For each patient that presented to the rural centre, cost of travel and productivity loss were also calculated, and compared to the closest metropolitan centre.

RESULT: Ninety-seven percent of the 38 participants strongly valued having a breast reconstruction service within their community. Eighty percent of participants were satisfied with their result. Patients were estimated to save on average $8478, by attending the rural breast reconstruction service.

CONCLUSION: Access to a breast reconstruction is significantly impacted by geographical barriers. A rural breast reconstruction service can improve patient access and satisfaction, while also reducing the financial burden on patients.