Background
Despite aiming for equality access in Australia, breast reconstruction is more likely in younger women with private health insurance, and those who live in metropolitan areas. 1 We explored the demographics, patient-reported outcomes, and accessibility for patients undergoing breast reconstruction in a rural area.
Method
Following ethics approval from the local governing body, all patients who underwent breast reconstruction following mastectomy for breast cancer through a single rural breast reconstruction unit over a six-year period were included. Patient-reported outcomes were recorded through phone interviews conducted by the research team using a standardised questionnaire utilising Likert scales.
Results
Thirty-eight participants were included in the study. Eight were lost to follow-up. Eighteen patients had private health insurance. The average age was 52 years. Thirty-one were immediate reconstructions, with 13 free flaps performed and the remainder undergoing alloplastic reconstructions.
97% of participants strongly valued having a breast reconstruction service within their community, with only 30% stating they would definitely consider undergoing a reconstruction if required to travel to the closest metropolitan center. Patient satisfaction rates were also high, with 80% of participants being satisfied with their result.
Discussion
The rates of breast reconstruction in Australia are estimated to be as low as 18%, with other studies stating that approximately 50% of women will undergo breast reconstruction if given the opportunity. Rurality has been identified as being a primary barrier1, 2. Our data supports these findings and emphasises the challenges placed on rural patients seeking breast reconstruction services.
Conclusion
Breast reconstruction is underrepresented in rural and remote areas for numerous reasons. A rural breast reconstruction service can have a substantial impact on this cohort of patients, improving patient access and satisfaction.