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Understanding patient choices regarding breast reconstruction after mastectomy for breast cancer

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Abstract

Purpose

In Australia, about 40% of patients undergo mastectomy to treat breast cancer, with negative impacts on body image, sexual function and quality of life. Whilst breast reconstruction is associated with increased patient self-esteem and a greater sense of wholeness and well-being, the national reconstruction rate is low at 18%.

This study aimed to compare demographics, treatment factors and information provision about breast reconstruction in women who had and did not have breast reconstruction following mastectomy treatment and identify goals and concerns underpinning women’s reconstruction decisions.

Methods

Female patients who had a mastectomy to treat breast cancer between 2010 and 2014 in a culturally and linguistically diverse (CALD) and socially disadvantaged region participated in a cross-sectional study, completing a questionnaire in their language of choice (English, Vietnamese, Chinese or Arabic).

Results

Completed surveys were returned by 168 women (42% response rate; 77% English-speaking), of whom only 19.0% (n = 32) reported having had breast reconstruction. Reconstruction rates were significantly lower in women who reported speaking a language other than English at home versus only English (37.5% vs 62.5%, p = 0.03). However, all women expressed a desire for more information about breast reconstruction and more support to make their decision about breast reconstruction.

Conclusions

Patients identified a need for greater information provision on breast reconstruction, highlighting an urgent need for resources specifically about breast reconstruction, particularly for non-English-speaking patients. Greater provision of information prior to mastectomy is critical to underpin breast cancer patients’ decisions about breast reconstruction, especially for non-English speaking patients.

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Acknowledgements

The authors gratefully acknowledge the assistance of Joseph Descallar with statistical analysis.

Funding

Funding for this project was through the South Western Sydney Local Health District Mid-Career Research Grant Support to PSS, and AG is funded through Cancer Institute NSW grants.

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Authors and Affiliations

  1. Department of Surgery, Bankstown Hospital, Eldridge Rd, Bankstown, NSW, 2200, Australia

    P. S. Soon, H. T. J. Mo, D. Segara & S. Yarrow

  2. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia

    P. S. Soon & A. Girgis

  3. Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia

    P. S. Soon, S. Ruban & A. Girgis

  4. Department of Surgery, Fairfield Hospital, Prairiewood, NSW, 2176, Australia

    R. Lee & L. Saliba

  5. Department of Surgery, Liverpool Hospital, Liverpool, NSW, 2170, Australia

    A. Shah

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  1. P. S. Soon
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  3. H. T. J. Mo
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Correspondence to P. S. Soon.

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Soon, P.S., Ruban, S., Mo, H.T.J. et al. Understanding patient choices regarding breast reconstruction after mastectomy for breast cancer. Support Care Cancer 27, 2135–2142 (2019). https://doi.org/10.1007/s00520-018-4470-0

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  • DOI: https://doi.org/10.1007/s00520-018-4470-0

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