The RESTORE C19 Study: Outcomes for women denied immediate breast reconstruction in the United Kingdom during the first wave of the COVID-19 pandemic.

Abstract Purpose The RESTORE C19 study aimed to explore outcomes for women not offered immediate breast reconstruction (IBR) following mastectomy for breast cancer during the first wave of the COVID-19 pandemic in the UK. Methods Women who were not offered IBR during the first wave of the COVID-19 pandemic (March-October 2020) were identified from the B-Map-C study database. Local collaborators were contacted between December 2021 and July 2022 to provide follow up data on the cohort, specifically whether women had been seen to discuss delayed breast reconstruction (DBR) and if so by whom; the receipt and timing of delayed reconstruction or documented decisions not to pursue reconstruction. Results Of the 366 women who were not offered IBR, complete follow-up data were available for 311 (85.0%). At a time point of between 21–28 months after mastectomy, less than half of women (n = 149, 47.6%) had been seen by a surgeon to discuss DBR and less than a third (n = 91, 29.2%) had been referred to plastic surgery to discuss autologous options. Only 21 (6.8%) women had actually received a DBR (4 with implant, 17 with autologous tissue). Almost one in five (n = 57) had decided against reconstructive surgery. Conclusions The majority of women denied IBR during the first wave of COVID-19 are still waiting for reconstructive surgery with almost 20% deciding not to pursue this option. Qualitative work is now needed to explore the experiences of this group in more detail to determine how best to support these women to complete their breast cancer journeys.