In Australian women who have undergone surgical removal of the breast (mastectomy) to treat breast cancer, only 12% also have surgery to rebuild the breast shape (breast reconstruction). This low figure continues despite proven safety and patient satisfaction with the procedure.

International studies have found that a number of surgeons did not provide reconstruction information to their patients or did not refer patients for this procedure. This was due to concerns with the safety of the procedure (particularly for patients who required further therapy after surgery, such as radiotherapy or chemotherapy), the older age of the patient, a lack of surgeon knowledge about reconstruction and the lack of a plastic surgeon referral service.

This study involved reviewing audit data and patient records for all cases performed by two surgeons in an Australian specialist breast cancer treatment centre between 2009 and 2011. The surgeons discussed all forms of reconstruction with every patient and the final choice regarding reconstruction was made by the patient.

Younger age of patient and size of invasive tumour were found to be the biggest factors in deciding to have reconstruction. The main reason for not undergoing reconstruction was patient choice, followed by surgeon considering the tumour to be 'high-risk' of cancer returning.

Overall, breast reconstruction was chosen by 41% of patients in this study, over three times the national average. A similar increase in negative outcomes of surgery was not seen.

The rate of surgical complications was similar between those who had immediate breast reconstruction and the wider group of those who had breast reconstruction at all. The majority of patients who did experience complications did not have a delay in commencing chemotherapy or radiotherapy treatment.

These results provide evidence that immediate breast reconstruction does not necessarily delay therapy and that surgical complications are not necessarily more frequent for women who choose reconstruction compared with women who do not. Therefore, discussing reconstruction options with all women appears a valid option for surgeons and can increase the number of women choosing reconstruction.