Calgary surgeon says breast cancer patients need better access to reconstructive surgery

CALGARY- It’s been almost a year since Calgary mom Kirsten Boulay underwent a double mastectomy and breast reconstruction surgery in order to reduce her cancer risk.

“My mom was lost to breast cancer, her sister (my aunt) and their mother,” said Boulay. “It was a lot of stress going into the decision but literally the morning after, there was an incredible weight lifted off my shoulders that I would live to be a grandmother.”

Because of a new treatment protocol piloted at the Foothills Medical Centre, Boulay was able to go home the same day as her surgery. Enhanced Recovery After Surgery (ERAS) gives patients like Boulay anti-nausea and anti-inflammatory medication before surgery so they’re better able to recover post-op.

A pilot study involving 29 breast reconstruction patients found that using the protocol, most patients were able to be discharged the same day as their surgery instead of having to be hospitalized overnight.

“Traditionally, I would say over the past 10 years, women having a mastectomy and or reconstruction stay an average of two nights in hospital, so this taking it down to zero, “said Dr. Claire Temple-Oberle, a plastic surgeon at the Tom Baker Cancer Centre.

If the protocol was adopted province-wide, Alberta Health Services estimates it would save 1,600 bed days a year. While that would improve access for Albertans who need inpatient hospital care, Temple-Oberle said access to reconstructive surgery itself continues to be challenging.

“It’s a long wait to get into a plastic surgeon to be seen, and once you’ve been seen, there’s a long wait to your reconstruction.”

According to Temple-Oberle, patients who can tolerate immediate reconstruction following a mastectomy have the best chance at accessing surgery quickly. Those that can’t may wait up to two years to have the procedure. Each year 1,000 Albertans undergo mastectomies but only 10 per cent have reconstructive surgery done.

“We lack a provincial program for breast reconstruction. We need more surgeons doing this work and to be coordinating in a way to maximize efficient use of resources. Without that, we aren’t going to make good headway in decreasing wait times.”