Improving equitable access to breast reconstruction in Australia
The Australian Access to Breast Reconstruction Collaborative Group (AABRCG) is a national, multidisciplinary initiative established in 2020 to improve equitable access to breast reconstruction services for people undergoing mastectomy for breast cancer, and for those at high inherited risk of breast cancer.
The Group brings together surgical, primary care, consumer and health policy expertise through a partnership between Breast Surgeons of Australia and New Zealand (BreastSurgANZ), Australian Society of Plastic Surgeons (ASPS), and Breast Cancer Network Australia (BCNA), with representation from research, general practice and clinical registries.
Our vision
That all people in Australia who require mastectomy for the management or prevention of breast cancer have timely, informed and equitable access to breast reconstruction, regardless of geographical location or financial circumstance.
Why this work matters
Breast reconstruction is widely recognised as part of best-practice breast cancer care. When offered appropriately, reconstruction can improve psychosocial wellbeing and quality of life without compromising cancer outcomes. Despite this, access to reconstruction in Australia remains inconsistent, with marked variation by geography, hospital capability and funding model.
Key barriers include limited availability of reconstructive services in regional and rural areas, lack of timely informed discussion prior to mastectomy, workforce and service constraints, financial barriers, and fragmented data collection.
Purpose and objectives
The AABRCG works to:
- Improve access to breast reconstruction for all people diagnosed with breast cancer or at high inherited risk
- Ensure reconstruction options are discussed prior to mastectomy
- Support equitable access for regional and remote patients, including via telehealth
- Inform and support GPs and referring clinicians
- Foster collaboration between breast and plastic surgeons
- Identify system-level barriers to access
- Advocate for nationally consistent policy and service delivery
Position statements and advocacy
The AABRCG has released national position statements outlining minimum standards of care and policy priorities, including access to post-mastectomy breast reconstruction and equitable access to reconstruction in both public and private health systems.
Prioritising access to risk reducing surgery for people with inherited high risks of breast cancer
The AABRCG has launched a joint position statement ‘Prioritising access to risk reducing surgery for people with inherited high risks of breast cancer’ which calls for national consistency in the categorisation of prophylactic mastectomy and reconstruction for people with inherited high risks of breast cancer.
Currently, risk reducing surgeries aren’t consistently classified as semi-urgent elective surgeries in public health services. While most state-based health services commit to scheduling prophylactic mastectomies within 12 months, many people with inherited high risks of breast cancer are forced to wait over 12 months due to workforce shortages and other factors. For some people, delays have exceeded five years.
Knowledge of risk is empowering but it becomes a feeling of being powerless when forced to spend years on public wait lists for preventative surgery. It’s a constant state of fear compounded by lack of transparency timelines and the reality is some will receive a breast cancer diagnosis whilst waiting. We must do better!
Access to Post-mastectomy Breast Reconstruction Information and Services in Australia
This purpose of this positions statement is to:
- raise awareness of the importance of discussing options for breast reconstruction for patients with a diagnosis of breast cancer for whom mastectomy is recommended
- to give guidance to those in a position to deliver such information; and
- to set out what minimum services should be available to women in Australia and outline optimal care.
Collaboration and governance
The AABRCG operates through a multidisciplinary membership with rotating chairmanship, ensuring balanced representation across surgery, consumer advocacy, research and primary care.
Dr Melanie Walker, BreastSurgANZ
A/Prof Kylie Snook, BreastSurgANZ
Dr Brigid Corrigan, ASPS
Dr Joe Dusseldorp, ASPS
Dr Gillian Farrell, ASPS
Flip Cardigan, ASPS
Dr Danielle Stewart, GP
Ms Vicki Durston, BCNA
Dr Jodi Steel, BCNA
Learn more
For further information, position statements and resources, please email [email protected]
