Type of barrier Issue Number of responses Median Mean Range (%) Priority ranking
Resource Lack of experienced BR surgeons 30 72.0 70 35–100 16
Lack of experienced operating theatre staff and specialised BR equipment 27 66.0 63 21–100 18
Lack of operating time 30 72.5 69 25–100 15
Lack of funding 28 78.0 70 17–100 9
Lack of MDT support 25 80.0 72 35–100 6
Lack of mentoring of junior/isolated surgeons 30 75.0 70 28–100 11
Attitudinal Some breast surgeons do not discuss BR options 29 92.0 86 40–100 2
Some breast surgeons are opposed to BR 24 90.5 76 7–100 3
Some breast reconstructive surgeons do not work in public hospitals 19 55.0 63 24–100 23
Some breast reconstructive surgeons do not work outside major cities 19 74.0 71 31–100 12
Some breast surgeons do not keep up with the latest evidence on BR 25 65.0 67 23–100 20
Some breast surgeons have poor communication and mentoring skills 20 71.0 70 26–100 17
Some breast surgeons do not work with other subspecialty surgeons 16 58.5 61 22–100 21
Access No access to BR discussion 27 98.0 87 24–100 1
Inadequate BR information is provided 25 74.0 74 23–100 13
BR decision-making is rushed 15 85.0 74 30–100 5
Women cannot afford BR (even with private health insurance) 22 90.5 87 46–100 4
Long waiting times for BR in public hospitals 24 79.5 75 42–100 8
Long distances to travel for BR 17 73.0 71 39–100 14
Some hospitals will not accept ‘out of area’ referrals for BR 24 55.5 62 20–100 22
Inadequate practical support for women seeking/having BR 23 54.0 61 21–100 24
Inadequate emotional support for women seeking/having BR 22 65.5 63 18–100 19
Inadequate continuity of care postoperatively 22 50.0 54 5–100 25
Inadequate targeted assistance for culturally and linguistically diverse and low literacy women 21 80.0 67 22–100 7
Women are not able to participate in clinical trials that may benefit them 21 76.0 65 6–100 10