Abstract Background Breast reconstruction after mastectomy provides quality of life comparable to breast-conserving surgery. Guidelines recommend offering reconstruction to all suitable patients, either delayed or immediate. This study assessed factors influencing the offer of immediate breast reconstruction (IBR). Methods Patient records (2022–2024) from a London district general hospital were retrospectively reviewed. Age, ethnicity, BMI, comorbidities, and peri-operative clinic discussions were analyzed. Results Of 135 mastectomy patients, 59 (43.7%) were offered IBR, and 24 (40.7%) accepted. Most offered IBR were non-smokers or ex-smokers (98.3%), had a BMI 25 (54.2%), and were under 70 (91.5%). Women with BMI 35 (5.1%) or major comorbidities (18.6%) were rarely offered IBR. All IBR patients were under 70, with 95.8% under 65. Women who declined IBR tended to be older; 31.4% were over 60, and 11.4% were under 50. Conclusion Older age, higher BMI, and major comorbidities reduce the likelihood of being offered IBR, raising potential equity concerns. Younger women were more likely to accept IBR, possibly due to concerns about body image and fewer health barriers. Improving health and functional status may increase IBR rates.
Stoner et al. (Fri,) studied this question.
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