Introduction: Breast reconstruction has superior post-operative quality of life (QoL) outcomes compared to mastectomy. During the COVID-19 pandemic, however, breast reconstruction services across the UK were restricted. In Aberdeen Royal Infirmary, breast reconstruction was unavailable from March to September 2020. The aims of this study were to determine how many patients were affected and how this restriction has impacted the physical, psychosocial, and sexual wellbeing of these patients.

Materials & Methods: Patients who underwent mastectomy or breast reconstruction surgery in Aberdeen Royal Infirmary from 18th September 2019 to 18th September 2020 were identified from admissions lists. Breast Q questionnaires were administered via post to all eligible individuals. Participants were asked if they would have preferred reconstruction had it been offered. QoL scores were compared between 2 groups; 1) patients who underwent breast reconstruction prior to restriction of services and 2) patients who were not offered but would have preferred reconstruction. Data analysis was carried out using SPSS statistical software.

Results: 164 patients underwent procedures during the period, of which 147 were eligible to participate. 105/147 (71.4%) completed questionnaires were returned. Of those who had a procedure post-COVID restrictions, 15 (27.8%) stated they would have preferred reconstruction had it been offered. Lower QoL scores were observed in group 2 compared to group 1 in both psychosocial wellbeing (medians 49 and 63 respectively, p=0.022) and sexual wellbeing (medians 37.5 and 51.5 respectively, p=0.026).

Conclusions: Loss of breast reconstruction services affected 27.8% of patients. We demonstrate the negative impact this had on psychosocial and sexual wellbeing, which provides key information on impact of loss of resources from this service to aid balanced decision-making regarding service provision in the future.

Breast cancer, Breast reconstruction, Patient reported outcome measures, COVID-19, Breast surgery