Restore C19: Experiences of women not offered immediate breast reconstruction during COVID-19

Introduction: The offer of immediate breast reconstruction (IBR) was temporarily withdrawn for women requiring mastectomy during the COVID-19 pandemic to allow prioritisation of emergency care. The RESTORE C19 study aimed to use qualitative interviews to explore the experiences of these women and how support for them could be improved. Methods: Qualitative interviews were undertaken with a purposive sample of women identified as not being offered IBR in the B-MaP-C study. Maximum sample variation was sought regarding patient age, decisions regarding subsequent reconstruction and geographical location. Data were transcribed in full and analysed thematically using the constant comparison technique of grounded theory. (Ethical approval: IRAS 302580, Wales REC 4 21/WA/0347). Results: Work is ongoing but key themes identified include feelings of abandonment and lack of support; frustration at missing out on the range of reconstructive options and ongoing post traumatic symptoms for patients and their partners. Most women understood and accepted why extreme measures were taken, but nonetheless experienced significant fear and trauma at facing breast cancer treatment alone, without the support of loved ones, guilt at receiving treatment when others missed out on cancer screening and many now face lengthy waiting times to access delayed reconstruction. Conclusions: The impact on women having breast cancer treatment during the COVID-19 pandemic was significant and effects are ongoing, especially for those still awaiting delayed reconstruction. This work explores the experiences of these women in detail so that they can be better supported and provides valuable learning regarding the delivery of future reconstructive services.