Changes in breast reconstruction over the COVID-19 pandemic: a single centre experience

Abstract

**Introduction**: Approximately 4000 Australians undergo mastectomy annually, yet there is a paucity of published Australian data on how the COVID-19 pandemic affected breast reconstruction services. The aim of this study is to determine the impact of the COVID-19 pandemic on the breast reconstructive service of a busy metropolitan hospital in Melbourne, Australia. Challenges in clinical service provision and surgical outcomes are discussed and compared with the published literature. **Methodology**: A single centre retrospective review of breast reconstruction over a four-year period (April 2018 to March 2022 inclusive) was conducted. Data collected include patient demographics, oncological attributes, surgical management and outcomes. Data was compared before (April 2018 to March 2020, inclusive) and during the COVID-19 pandemic (April 2020 to March 2022, inclusive). **Results**: Resection rates were comparable before and during the COVID-19 pandemic (240 versus 248 patients). There was an increase in the rate of mastectomies compared to breast-conserving operations between the two periods (30.4% versus 45.6%, p < 0.001). Breast reconstruction post-mastectomy increased from 39.7 per cent to 46.0 per cent (not statistically significant, p = 0.68). The rate of immediate breast reconstruction (79% versus 81%) and autologous reconstruction (62% versus 70%) were statistically similar between the two periods. There was no difference in total pre-COVID-19 and post-COVID-19 complication rates. **Conclusion**: Our experience demonstrates that acceptable oncological and reconstructive outcomes for breast cancer can be achieved in the middle of a pandemic without compromising outcomes.