Providing timely access to risk reducing surgery for your patients

Healthcare professionals play a crucial role in ensuring patients’ timely and equitable access to treatment options – including risk-reducing surgery such as prophylactic mastectomy.

A united and unprecedented position statement from Breast Surgeons of Australia and New Zealand (BreastSurgANZ) and Breast Cancer Network Australia (BCNA) was made to the Federal Government on 21 November 2024 to improve access for women wanting preventative mastectomies due to high genetic risk.

We are calling for a nationally consistent approach in prioritising access to prophylactic (risk-reducing) mastectomy.  This surgical procedure can reduce a person’s risk of getting breast cancer by at least 95%.

People with inherited high risks of breast cancer often wait more than 12 months for these risk-reducing surgeries. They also face higher rates of emotional distress and generational trauma associated with cancer risk, and the possibility of premature death.

Currently, risk-reducing surgeries are not consistently classified as semi-urgent elective surgeries in public health services. Alternative pathways through the private health system can cost patients as much as $50,000, making it an impossible option for many.

 A nationally consistent approach to the prioritisation of risk reducing surgery for people with inherited high risks of breast cancer will help reduce the risk of breast cancer diagnosis. This removes the need for and cost of breast cancer treatments including chemotherapy and radiation. 

Background

BCNA has consistently heard people with inherited high risks of breast cancer talk about their challenges accessing risk reducing options. Some have said that there is a lack of information and support to effectively make an informed decision about what is best for them.

While most health services committed to scheduling prophylactic mastectomies within 12 months from the time of waitlisting, some people have waited over five years. 

We have observed distressing cases where individuals with inherited risks develop breast cancer while waiting for their risk reducing surgery, some with metastatic cancer that has already spread to other parts of the body. This has led to long term impacts on psychosocial wellbeing, including the distress and trauma that comes with having incurable breast cancer.

We know that prioritising risk reducing surgery is not only compassionate but also cost-effective. Given that hereditary breast cancers account for 5-10% of all breast cancers, they are estimated to cost $39-79 million annually.

Providing prophylactic mastectomies to people with inherited high risks of breast cancer could save the healthcare system tens of millions of dollars every year by preventing cancer and reducing the need for more intensive treatments. 

It is BCNA’s position that governments, health professionals and hospitals prioritise prophylactic mastectomies for people with inherited high risks of breast cancer to meet the urgency of their healthcare needs. 

Linda's story

Linda waited almost three years for her prophylactic mastectomy. She found out she had a BRCA1 gene mutation in 2019, a month after turning 50.

It was a huge shock to receive this news. For her, it was no different to getting a breast cancer diagnosis.

Linda has a strong family history with cancer. Her elder aunt died of ovarian cancer in her 50s and her younger aunt was diagnosed with breast cancer in her 40s. 

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