THEL Breast cancer in Italy affects 1 in 8 women over the course of life. In the vast majority of cases, oncological treatment involves more or less destructive surgery. To recover physical integrity, or simply natural and pleasant forms, reconstructive surgery is necessary. Wednesday October 18th all over the world it is celebrated Bra Day, the international day for awareness of post-oncological breast reconstruction. To raise awareness on the topic, al A. Gemelli University Hospital IRCCSin the MediCinema room, the Beautiful After Breast Cancer Italia Onlus will stage a show, bringing doctors, patients and people, especially women, from the world of entertainment and sport onto the stage.
Breast cancer and the NHS
«The National Health Service only covers the costs of the mastectomythe demolition phase of the intervention, providing for the deferred reconstruction. We know well that for the woman who faces the disease, immediate reconstruction is fundamental, which unfortunately is not reimbursed with any method, but is carried out at the expense of individual hospitals. Not only. The NHS covers the cost of reconstruction with flaps, i.e. with its own tissues, on a deferred basis and with reimbursements so small that they discourage hospital companies from using this advantageous technique for women. In the face of greater survival we must improve the quality of life of our patients”, launches the appeal Professor Marzia Salgarelloreconstructive plastic surgeon at the Agostino Gemelli IRRCS University Polyclinic Foundation and President of BABC Italia Onlus.
Prosthetics VS own tissues
«The NHS does not provide a code for immediate reconstruction. Large hospital companies with large numbers carry it out at their own expense, but this is not possible for small hospitals with small budgets. All of this it affects the quality of the reconstruction: the least expensive one is chosen, not the one most suitable for the individual patient. Always for a budget discussion, interventions with one’s own tissues tend to be avoided, technically more difficult and obviously also more expensive. Nevertheless prosthetics are not eternal. Their actual duration cannot be predicted a priori as it varies from woman to woman also based on the therapies carried out. What is known is that 1 in 10 breaks. The question of the prosthesis is also linked to the type of therapy: radiotherapy deteriorates the tissues and therefore can ruin the reconstruction”, explains the Doctor Liliana Barone AdesiMedical Director of the Plastic Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, and Vice President of BABC Italia Onlus.
Reconstruction with flaps: what are the advantages?
«If one is implanted unilateral prosthesisin time aging can cause a morphological change with the need to reshape the healthy breast to achieve symmetry. Ultimately, in the long term, reconstruction with prosthesis may require various corrective interventions. The interventions with your own tissues that is, the flaps, on the other hand, in the face of greater expenditure, both for the patient in terms of physical effort and for the healthcare company in terms of costs, have some much more stable results over time. We focus on the short term and ignore what will happen in the medium to long term”, underlines Dr. Barone Adesi.
Breast cancer: the costs of reconstruction
«According to a study in which I participated, with Professor Maria Lucia Specchia as the first signatory, indexed on Pubmedfor each mastectomy with immediate reconstructionthe healthcare company loses on average 1,719 euros. Precisely in light of these numbers, thanks to the interest of the Honorable Michela De Biase, in 2021 in the Lazio Region there was a promise of reimbursement, unfortunately never applied”, continues Professor Salgarello. In addition to focusing attention on the cost of the interventions, the project will be presented as part of Beautiful ABC Italia Woman X Woman, which brings together a large number of women doctors dedicated to breast cancer treatment. This year the project will be dedicated to physical-motor rehabilitation.
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