468 Free Flap Breast Reconstruction in the UK: Are We Meeting the Demand?

Abstract

Abstract The demand for free flap breast reconstruction appears to be increasing. This study aims to evaluate the capacity for microsurgical breast reconstruction across the UK and compare this to the apparent demand to inform future workforce planning. A questionnaire was sent to all the plastic surgery units in the UK to establish whether they performed reconstructive breast surgery, the number of free flaps they performed a year and what issues they were encountering in meeting the demand. The response rate was 92.8% of 56 units. Current workforce planning figures show that there are 161 Consultant Plastic Surgeons who perform free tissue breast reconstruction. Across the UK, the total number of extra breast reconstructive surgeons felt to be needed was 78. The mean number of free flaps per year per surgeon was 20 [11-37]. Responders suggested that they felt 20 [12-30] free flaps were a suitable number to maintain their skills. 66% of the responders reported issues impairing delivery of their free flap service with access to theatre (41%) and inability to meet the demand (18%) as 2 of the key reasons. Our results show that there is a demand for microsurgical breast reconstruction that is not being fully met at present. The authors hope that this survey may add to the evidence base that plastic surgeons remain an integral part of the care of many breast cancer patients and will encourage trainees to consider it as a subspecialty of choice.