Abstract
BackgroundThe aims of the study were to investigate the factors associated with not having breast reconstruction following mastectomy and to assess patient satisfaction with information on reconstruction.Patients and methodsWe analysed a historical cohort of 1937 consecutive patients who underwent mastectomy at Institut Curie between January 2004 and February 2007. Their sociodemographic and clinicobiological characteristics were recorded in a prospective database. A questionnaire was sent to 10% of nonreconstructed patients.ResultsThe proportion of patients with invasive cancer was 82.7%. The rate of nonreconstruction in patients with in situ and invasive cancer was 34.6% and 74.9%, respectively. On multivariate analysis, only employment outside the home was associated with reconstruction in patients with in situ cancer (p < 0.001). In patients with invasive cancer, employment status (p < 0.001) and smoking (p = 0.045) were associated with reconstruction, while age > 50, ASA score >1, radiotherapy (p < 0.0001) and metastatic status (p = 0.018) were associated with nonreconstruction. For 80% of questionnaire responders, nonreconstruction was a personal choice, mainly for the following reasons: refusal of further surgery, acceptance of body asymmetry, risk of complications and advanced age. Information on reconstruction was entirely unsatisfactory or inadequate for 62% of patients.ConclusionBetter understanding the factors that influence decision of nonreconstruction can help us adapt the information to serve the patient’s personal needs.
Highlights
About 52,500 women are diagnosed with breast cancer in France every year (La situation du cancer en France 2010)
The questionnaire was prepared in collaboration with a panel of 8 patients who had undergone mastectomy only and a panel of medical and paramedical professionals working in the field of breast cancer
The majority of patients with breast cancer who undergo mastectomy do not proceed with breast reconstruction
Summary
About 52,500 women are diagnosed with breast cancer in France every year (La situation du cancer en France 2010). What emerges across all studies is that the majority patients do not have reconstruction following mastectomy (Table 1) The aims of the study were to investigate the factors associated with not having breast reconstruction following mastectomy and to assess patient satisfaction with information on reconstruction
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