Perspectives of Wisconsin Providers on Factors Influencing Receipt of Post-Mastectomy Breast Reconstruction

Abstract

BackgroundThe objective is to determine perspectives of general surgeons, plastic surgeons, and cancer navigators on factors contributing to breast cancer patients’ decision for post-mastectomy reconstruction, especially for women facing financial hardship. MethodsWe mailed Wisconsin general and plastic surgeons who performed >5 breast cancer procedures annually a survey, including a postcard inviting cancer navigators to participate. Descriptive statistics summarize item responses. McNemar's chi-squared tests evaluated surgeons’ perspectives of factors influencing reconstruction for all women compared to women facing financial hardship. ResultsRespondents include 70 general surgeons, 18 plastic surgeons, and 9 navigators. Respondents perceived preference-related factors as important, including “does not want more surgery” (85% reported it important overall and 77% for financial hardship women) and “reconstructed breast is not important to her” (77% vs. 61%). Surgeons perceived logistical factors were more important for women facing financial hardship, including “capacity to be away from work or home responsibilities for recovery” (30% reported important overall and 60% for financial hardship women), “concerned about out-of-pocket costs” (26% vs. 57%), and “frequent visits to complete reconstruction too burdensome” (27% vs. 49%). ConclusionOur findings demonstrate Wisconsin surgeons and cancer navigators perceive logistical concerns influence reconstruction decisions for women facing financial hardship.