Postcode lottery for reconstructive surgery

A few days before undergoing a mastectomy to remove her left breast, Helen Williams, a 55-year-old fitness instructor from Surrey, bid an emotional farewell to her favourite lingerie. “Before the operation I said goodbye to all my beautiful underwear and put it away; I didn't believe I would be able to look good in nice clothes again,” says Williams, a mother of two. The former nurse had breast cancer diagnosed in 2005 after a routine mammogram. Doctors told her that the cancer was too widespread for a lumpectomy (the removal of only the tumour and surrounding tissue) and radiotherapy, and that a mastectomy was the best option.

“As an ex-nurse I remembered what mastec-tomies used to be like in the 1970s. It was a pretty grim prospect. I was very nervous beforehand,” she says. Breast cancer is diagnosed in more than 40,000 British women every year and around 14,000 have mastectomies.

The operation involved a little-known reconstruction technique called deep inferior epigastric perforator, or Diep. This technique is considered by some specialists to be the gold standard and involves reconstruction of the breast using skin and fat from the lower abdomen. Since that surgery she has had nipple reconstruction to enable her to look as natural as possible. “I'm absolutely delighted that I had it done. You wouldn't know that I've had anything done,” Williams says.