Perspectives of Women Who Forgo Post-mastectomy Breast Reconstruction: A Mixed Methods Analysis. 

 -  2021 
<br/><br/> 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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>2169-7574 
<br/><br/><label>Standard No.: </label>10.1097/GOX.0000000000003203 [doi] PMC7929531 [pmc] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>IN PROCESS -- NOT YET INDEXED
<br/><br/><label>Subjects--Geographic Terms: </label><br/>Curtis National Hand Center <br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Surgery/Plastic Surgery
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article