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What affects women’s decision-making on breast reconstruction after mastectomy for breast cancer?

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Abstract

Purpose

To establish the breast reconstruction rate in a large Dutch teaching hospital, and to gain insight into the motives of women to opt for or reject post-mastectomy breast reconstruction.

Methods

In a retrospective, cross-sectional study, all consecutive patients who underwent mastectomy for invasive breast cancer or ductal carcinoma in situ (DCIS) were identified and categorized into two groups based on subsequent breast reconstruction or not. Patient-reported outcomes were assessed with the validated Breast-Q and a short survey about the decision-making process in breast reconstruction. These outcomes were compared between the two groups using univariable analyses, multivariable logistic regression, and multiple linear regression analyses. The Breast-Q scores were also compared to Dutch normative values.

Results

A total of 319 patients were identified of whom 68% had no breast reconstruction. Of the 102 patients with breast reconstruction, the majority (93%) received immediate, instead of delayed breast reconstruction. The survey was completed by 155 (49%) patients. The non-reconstruction group, on average, reported significantly poorer psychosocial well-being, compared to the reconstruction group as well as compared to the normative data. However, the majority of the non-reconstruction group (83%) stated that they had no desire for breast reconstruction. In both groups, most patients stated that the provided information was sufficient.

Conclusion

Patients have personal motives to opt for or reject breast reconstruction. It seemed that patients differ in their rating of values that affect their decision since the same arguments were used to opt for or reject reconstruction. Notably, patients were well-informed in their decision making.

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Author information

Authors and Affiliations

  1. Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands

    Sara van Bekkum & Marian B. E. Menke-Pluijmers

  2. Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands

    Marloes E. Clarijs & Linetta B. Koppert

  3. Department of Plastic Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands

    Fientje J. C. van der Veen

  4. Department of Biostatistics, Erasmus Medical Centre, Rotterdam, The Netherlands

    Joost van Rosmalen

  5. Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands

    Joost van Rosmalen

Authors
  1. Sara van Bekkum
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  2. Marloes E. Clarijs
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  3. Fientje J. C. van der Veen
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  4. Joost van Rosmalen
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  5. Linetta B. Koppert
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  6. Marian B. E. Menke-Pluijmers
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Correspondence to Marian B. E. Menke-Pluijmers.

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van Bekkum, S., Clarijs, M.E., van der Veen, F.J.C. et al. What affects women’s decision-making on breast reconstruction after mastectomy for breast cancer?. Breast Cancer 30, 772–784 (2023). https://doi.org/10.1007/s12282-023-01471-4

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  • DOI: https://doi.org/10.1007/s12282-023-01471-4

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