The wait for breast reconstruction surgery after a mastectomy in Northland has rocketed over the past five years, from nine months to more than two years.

The delay can stop women from moving on from breast cancer and leave them with feelings of low self-esteem, experts say.

But Northland District Health Board says most women have breast reconstruction at the same time as a mastectomy and access to this is timely.

The small number of Northland patients getting breast reconstruction surgery alone are waiting an average of 332 days for their first specialist appointment and a further 489 days for surgery, information released under the Official Information Act shows.

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The wait time is three times greater than five years ago and the longest wait for selected types of surgery in New Zealand.

Breast Cancer Foundation research manager Adele Gautier said breast reconstruction surgery gave women a normal-looking breast after a mastectomy.

For those who chose to have reconstruction, it helped them to wear clothes more easily, feel more balanced and suffer less depression or body image problems, she said.

“Having a breast or both breast removed in surgery is hugely shocking for women … Reconstruction is about getting back to normal at a mental and emotional level.”

Of Kiwi women who have a mastectomy, 19% have breast reconstruction at the same time as the mastectomy, 4.5% have it after a delayed time and 76.5% have no breast reconstruction, the Breast Cancer Foundation found.

There could be clinical reasons for reconstruction not happening immediately, including the possibility it could delay further cancer treatment, like chemotherapy or radiation, Gautier said.

Other times, women could delay or chose not to have reconstruction for emotional reasons, she said.

“The evidence shows it improves their quality of life, but at the same time it’s a major procedure; it’s a big decision for some people to make.”

However, Ministry of Health guidelines say delayed reconstruction should be available to women in the public health service within a reasonable timeframe.

There was no way of telling how many women chose not to have reconstruction because of long wait times, Gautier said.

“It must be quite discouraging to be told there’s no hope of it in the couple of years.”

Northland District Health Board general manager of surgical and support services Mark McGinley said breast reconstruction ordinarily occurred at the same time as a mastectomy.

For those patients, the wait time between the decision to treat and the first treatment was an average of 36 days, he said.

Over the past six months, Northland had increased its surgical specialists for this area, which was expected to improve waiting times, he said.

In February, Whangārei Hospital postponed elective surgeries that required a bed overnight, due to pressures on the system and a surge in Covid-19 cases.

It had now started to move back to a normal case mix and volume, but this has been impacted by staffing levels and available beds, McGinley said.

“Inpatient bed capacity and staffing have limited our ability to return to normal,” he said.

In May, Health Minister Andrew Little announced a nationwide taskforce to tackle hospital waiting lists, led by interim Health New Zealand and the interim Māori Health Authority.

The two authorities become active on Friday.