Jane Hickling, 46, knew immediately what she wanted to do after learning she carried a genetic mutation that significantly increased her risk of breast and ovarian cancer. Having lost her mother to breast cancer, and with other women in her extended family affected by the disease, Jane opted for a preventative double mastectomy when genetic testing confirmed her high-risk status in 2023.
“I knew straight away I wanted preventative surgery as I was so worried about getting cancer,” Jane, a care worker from Bicester, Oxfordshire, and mother of four, told reporters. “I have yearly scans, but that doesn’t reassure me because something could grow in between.”
Nearly three years later, Jane is still waiting for the procedure. Her experience reflects a growing problem for women with “breast cancer genes” on the NHS, who are facing delays of years due to a shortage of surgeons and operating theatre capacity.
“My life is in limbo,” Jane says. “It’s driving me up the wall waiting. I know the recovery is going to be tough and take a while – I just want it over and done with.”
Rising Demand and Genetic Risk
Up to one in 300 women are believed to carry a mutated BRCA1 or BRCA2 gene. Women with these mutations face around a 70% lifetime risk of breast cancer, compared with just over 10% in the general population. The genes also increase the risk of ovarian cancer in women and prostate cancer in men, though researchers are still studying exactly how these mutations elevate cancer risk.
Doctors typically recommend annual mammograms and ovary scans for women with high-risk genes. Many are also offered risk-reducing surgery to remove breast tissue before tumors can develop. High-profile cases, such as Angelina Jolie’s double mastectomy and later ovary removal following the discovery of a BRCA mutation, have raised public awareness of these preventive options.
Surgery for risk reduction may include removal of the breast tissue with or without reconstruction, and procedures are generally completed in a single day to reduce recovery time and infection risk.
NHS Backlogs Worsened by the Pandemic
However, waiting lists for these major surgeries have worsened since they were suspended during the COVID-19 pandemic. A 2024 study by University Hospitals Coventry and Warwickshire NHS Trust found more than 2,200 women identified as genetically high-risk were waiting for surgery, with a projected backlog clearance time of around two and a half years.
Louise Grimsdell, senior clinical nurse specialist at the charity Breast Cancer Now, highlighted the human toll of these delays. “Many women with [a genetic risk] or significant family history face very long waits for risk-reducing and accompanying reconstructive surgery, as NHS services struggle to meet demand,” she said. “Long waits were worsened in some areas during COVID, and haven’t fully recovered across the UK.”
Real-Life Impact
Tracy Watson, 62, from Sheffield, describes her own ordeal. In 2019, doctors warned she was a “ticking time bomb” for breast cancer due to her family history. Despite a referral for a double mastectomy with an expected six-month wait, lockdowns, staff shortages, and backlog delays meant she did not have surgery until January 2023—over three years later. By that time, tissue in her left breast had become pre-cancerous.
“Every day you think: ‘Is this the day I’ll find a lump?’” said Tracy, who now volunteers to support other women navigating long waits.
Calls for Action
Experts warn that prolonged delays compound the distress of women already coping with the knowledge of their heightened cancer risk. A 2024 study found at least 40 women developed cancer while waiting for preventive surgery, a figure researchers called “alarming.”
Consultant plastic surgeon Simon Wood criticized the “postcode lottery” for risk-reducing surgery access. “There are so many pressures on surgeons’ time and theatre capacity that sadly these patients become lower priority in some trusts,” he said. “I am uncomfortable with them sitting on the waiting list because they are a time bomb – you don’t know when they are going to get cancer.”
Jane Hickling was offered a surgery slot in autumn 2024, but could not take it due to work and childcare responsibilities. The next date offered in November 2025 was canceled just two days prior due to staff shortages. At the time of reporting, she is still waiting.
An NHS spokesperson acknowledged the issue, stating: “We recognise how distressing it can be to be waiting for preventive surgery, and local NHS services should be working to ensure it is happening as soon as possible for women at high risk of breast cancer. Staff are working incredibly hard to bring down the longest waits for patients and the NHS is working with the most challenged trusts to ensure patients continue to see reductions in waiting times right across the country.”
