Understanding the factors that influence breast reconstruction decision making in Australian women

Background Breast reconstruction is safe and improves quality of life. Despite this, many women do not undergo breast reconstruction and the reasons for this are poorly understood. This study aims to identify the factors that influence a woman's decision whether or not to have breast reconstruction and to better understand their attitudes toward reconstruction. Methodology An online survey was distributed to breast cancer patients from Breast Cancer Network Australia. Results were tabulated, described qualitatively and analyzed for significance using a multiple logistic regression model. Results 501 mastectomy patients completed surveys, of which 62% had undergone breast reconstruction. Factors that positively influenced likelihood of reconstruction included lower age, bilateral mastectomy, access to private hospitals, decreased home/work responsibilities, increased level of home support and early discussion of reconstructive options. Most common reasons for avoiding reconstruction included “I don't feel the need” and “I don't want more surgery”. The most commonly sited sources of reconstruction information came from the breast surgeon followed by the plastic surgeon then the breast cancer nurse and the most influential of these was the plastic surgeon. Conclusions A model using factors easily obtained on clinical history can be used to understand likelihood of reconstruction. This knowledge may help identify barriers to reconstruction, ultimately improving the clinicians' ability to appropriately educate mastectomy patients and ensure effective decision making around breast reconstruction

A. E. Reaby

"VX110633 WOII AE Reaby 7 Aust Fld Survey Sec AIF Arrived: Darwin, 7.8.1944 Departed: Adelaide River, 13.4.1943"VX110633 Warrant Officer II A. E. Reaby. 7th Australian Field Survey Section, Australian Imperial Forces. Arrived: Darwin, 7.8.1944, Departed: Adelaide River, 13.4.1943.Date:199

Patient satisfaction: The importance of support in the decision-making process

Long are the days when the success of an operation was determined by the surgeon alone. Surgical teams are increasingly eliciting the opinions of patients themselves to ascertain surgery success, argues Catrin Griffiths. It is vital for clinicians to identify patient expectations and help patients to develop realistic surgical expectations, as meeting these are key to satisfaction