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Breast Surgery

Checked: 23-03-2023 by Vicky Ryan Next Review: 23-03-2025

Breast Surgery - funding policies

Please see the following funding policies that apply to breast surgery referrals in BNSSG ICB.

Breast Surgery (for females) - Breast surgery for all benign breast conditions in females is not routinely commissioned and would only be considered via an individual funding application. Patients who have had privately placed breast implants for cosmetic reasons that have ruptured and developed granulomas (usually axillary), are entitled to implant removal only. Removal of axillary granulomas is not routinely commissioned.

Breast Surgery (for males) - Breast surgery for all benign breast conditions in males (including gynaecomastia) is not routinely commissioned and would only be considered via an individual funding application.

Breast reconstruction post-cancer - This is a criteria based access policy and as long as criteria are met then prior approval/ funding is not required.

The policy does include long term access to support and surgical intervention agreed by Oncoplastic MDT for patients who have had breast reconstruction surgery including implant removal and replacement, or transition to the most appropriate reconstruction where required for NHS breast reconstruction patients and for private patients post cancer, who are no longer covered by the private sector.

Risk Reducing Mastectomy - This criteria based access policy confirms that patients who are identified as having a High Risk of developing Breast Cancer are eligible to access a Prophylactic Mastectomy without the need to secure additional funding.

Breast surgery for Gender Identity

Breast surgery for patients on the gender identity pathway (for both male and female patients) is commissioned by NHS England via Gender Identity Clinics (direct GP referrals would not be considered outside of this pathway).

Red Flags

Please see the Breast -2WW section for advice on referral for suspected malignancy

For patients with an acute breast abscess then please see the Mastitis and Breast Abscess section

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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