Perspectives of Women Who Forgo Post-mastectomy Breast Reconstruction: A Mixed Methods Analysis.
Citation: Plastic and Reconstructive Surgery - Global Open. 9(2):e3203, 2021 Feb.PMID: 33680631Institution: Curtis National Hand Center | MedStar Washington Hospital CenterDepartment: Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021ISSN:- 2169-7574
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 33680631 | Available | 33680631 |
CONCLUSIONS: Women in this study highlighted certain deficits in the current pathway to reconstruction: lack of trust, resources, and counseling. Such feelings of suspicion and reported opposition to PMBR are at odds with low scores for satisfaction with breasts and sexual well-being. These findings can be used to guide efforts that engender confidence, provide support, empower vulnerable patient groups, and increase utilization of PMBR. Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.
Despite a growing body of evidence suggesting improved psychosocial well-being and survival after post-mastectomy breast reconstruction (PMBR), rates remain stagnant at approximately 40%. Although PMBR access and utilization have been well reported, there is much less known from the point of view of women who decide not to undergo PMBR. This study uses a mixed methods approach to fill that gap by investigating the patient-level decisions that lead to foregoing PMBR.
METHODS: A concurrent triangulation model under mixed methods research (MMR) was employed using in-depth qualitative interviews and the BREAST-Q questionnaire. Interviews were conducted until data saturation was reached and were analyzed using iterative methodologies under the grounded-theory framework. Reliability checks included inter-rater reliability using Cohen's kappa statistic (mean kappa = 0.99) and triangulation.
RESULTS: Interviews with 8 patients who declined PMBR revealed (1) lack of trust in plastic surgeons; (2) reliance on self-developed support; (3) desire to resume normal life; (4) perceived lack of equivalency between reconstructed and natural breasts. Concurrent triangulation between the data revealed dissonance between the BREAST-Q scores for psychosocial well-being and reported levels of satisfaction.
English