Every time Julie Ford raises her arms to dress or to hang laundry, she is painfully reminded of one of the most distressing moments in her life. In April 2021, at 7 am, she entered the hospital alone, masked, to undergo surgery to remove her right breast and lymph nodes in an effort to prevent the spread of breast cancer. Later that same day, still recovering from anesthesia and in pain, she was assisted by two nurses as she made her way to the exit. A friend drove her home, where she had to manage on her own.
Although Julie had her breast surgically removed, reconstruction was not performed. Typically, mastectomy and reconstruction are conducted simultaneously; however, the complex nature of abdominal tissue reconstruction, which involves a lengthy eight-hour surgery and a large surgical team, led many NHS trusts to classify it as “non-essential” during the Covid-19 pandemic.
Like numerous other women who underwent urgent mastectomies without immediate reconstruction during 2020 and 2021, Julie was promised that she could receive the reconstruction once the pandemic restrictions were eased. However, five years later, at age 62, she is still awaiting her surgery.
A national deficit of specialized surgeons and surgical space, alongside the need to prioritize new cancer cases, has left many women like Julie feeling neglected. They endure ongoing physical discomfort and emotional distress while waiting for the reconstructions they were assured they would receive.
“I have to confront this awful situation every day,” Julie expresses with frustration regarding her post-mastectomy appearance. “It has severely impacted my self-esteem. I don’t feel right in my clothes as everything fits awkwardly. I’m so self-conscious—I struggle to go out or socialize—and I haven’t been able to pursue a relationship.”
Julie, a child social care support worker from Sheffield, had a temporary implant placed during her mastectomy. However, after undergoing radiotherapy, the implant fused to her body, causing it to become distorted and eliciting sharp pain with every movement. “It feels like it’s glued to the inside of my skin,” she explains. “I can’t lift my arm; it really pulls and hurts.”
After a year of recovery following her cancer treatment, Julie was added to the reconstruction waiting list in 2022. Unfortunately, cancer survivors like her are often at the bottom of the priority list for surgery slots. Patients with active cancer are understandably prioritized, receiving both mastectomies and reconstructions in one procedure. Any additional openings typically go to women at high genetic risk of developing breast cancer.
As a result, many cancer survivors awaiting delayed reconstructions find themselves at the end of the line, according to Simon Wood, an NHS consultant plastic surgeon and president-elect of the British Association of Plastic, Reconstructive and Aesthetic Surgeons. He notes that while some NHS trusts, such as Imperial College Healthcare NHS Trust, have made efforts to ensure no patient has to wait longer than a year for reconstruction, others appear to have made little progress since the pandemic. A study conducted in 2024 revealed that over 2,200 breast cancer survivors, or those at high risk, were waiting for surgery across 40 NHS facilities in England, with an average waiting period of 2.5 years.
Wood expresses concern that hospitals lack the motivation to address the backlog effectively. Instead of allocating resources toward lengthy and costly surgeries like breast reconstructions, NHS trusts aiming to decrease their overall waiting lists are incentivized to prioritize quicker, simpler procedures that can clear multiple patients in a shorter time frame. “There are capacity challenges, with increasing demand and a shortage of available surgical time and skilled surgeons,” he notes, “but resolving this issue requires NHS management that is committed to finding solutions rather than remaining inactive.”
For 63-year-old Alison Wilson from Stockport, Greater Manchester, the prolonged wait for breast reconstruction brings daily heartache. “I just want to reclaim the part of me that’s missing—to look and feel like myself again,” she says, breaking into tears. “My confidence has plummeted. I deeply admire women who can reveal their scars, but that’s not me. I yearn for some semblance of normalcy after enduring so much loss.”
Alison underwent a mastectomy in April 2020 following a cancer diagnosis but has been informed she must wait until September of this year for reconstruction surgery. In the interim, she has been provided with a prosthesis to replace her missing breast, which she finds uncomfortable. “It’s particularly unbearable in hot weather,” she adds. Working in airport security, Alison frequently encounters body scanners that detect her prosthesis as an anomaly. “Every day at work, I worry about having to explain my breast situation to a stranger,” she sighs. “It’s impossible to forget—it’s a constant reminder.”
Similar to Julie, Alison was discharged from the hospital on the same day as her mastectomy and was expected to recover at home. At that time, she was shielding with her husband, who has a severe chronic lung condition. “I felt completely numb,” she recalls. “We had suddenly found ourselves in lockdown. My husband’s health was worsening, and I could only wave at my newborn grandchild through a window. Being told I had to undergo a mastectomy was surreal. I couldn’t process it.”
Alison was informed that breast reconstruction surgeries were on hold due to lockdown restrictions but never received further communication from her medical team. It was only through a chance conversation that she learned more about her situation.
