A national audit has shown only one in 10 women have reconstructive surgery at the same time as mastectomy despite guidance that it should be offered to all.
Jean Pearce, aged 64 from Worcester, was shocked to hear so many women did not have a choice and considers herself very lucky.
She was diagnosed with breast cancer in 2005 and initially had a lumpectomy but was then told she would have to have the whole breast removed.
"My surgeon in Worcester didn't do the reconstructive surgery I was after so he referred me to a colleague.
When you say you've had breast cancer to anybody, the first thing they do is look at your breasts
"He was brilliant, he gave me a video of all the options you can have and then you have to work out which is the best for you."
Jean had a couple of months between her initial lumpectomy and further surgery to think through her decision.
But she knew having the later operations separately was not an option.
Reconstruction was important for her self-esteem.
"I'm not a patient person and I didn't think mentally I would be able to cope with that.
"It's quite important because you go down to surgery with a breast and you come back with a breast.
"I didn't have to go through that awful scenario of feeling inadequate.
"When you say you've had breast cancer to anybody, the first thing they do is look at your breasts. They don't mean to - it's just a natural reaction.
"And then you would be even more self-conscious."
She says she feels incredibly lucky and did not realise until recently that so many women were being denied such surgery.
"I have a colleague in Wales and she was told she was too old.
"Women should not have to ask or beg."