Preferred Breast Reconstruction Method Tied to Varying Attributes

Oct 03, 2023

MONDAY, Oct. 2, 2023 (HealthDay News) — Women considering breast reconstruction preferentially value different attributes of their treatment, according to a study published online Sept. 27 in JAMA Surgery.

Ronnie L. Shammas, M.D., from Duke University in Durham, North Carolina, and colleagues sought to understand which attributes of breast reconstruction are most important to women considering surgery. The analysis included 105 women with a new diagnosis of or genetic predisposition to breast cancer who were considering mastectomy with reconstruction and being seen at Duke University and 301 women with a history of breast cancer or a genetic predisposition participating in the Love Research Army registry.

The researchers found that the attribute considered most important was the risk for abdominal morbidity (mean relative importance [RI], 28 percent), followed by chance of major complications (RI, 25 percent), number of additional operations (RI, 23 percent), appearance of the breasts (RI, 13 percent), and recovery time (RI, 11 percent). Implant-based reconstruction was preferred by most participants (85 percent), and these participants cared most about abdominal morbidity (mean RI, 30 percent), followed by the risk for complications (mean RI, 26 percent) and additional operations (mean RI, 21 percent). Among participants who preferred flap reconstruction, additional operations (mean RI, 31 percent), appearance of the breasts (mean RI, 27 percent), and risk for complications (mean RI, 18 percent) were the most important factors. Flap reconstruction was independently associated with being married (odds ratio, 2.3) and higher educational level (college education; odds ratio, 2.43). Participants who preferred flap appearance reported more willingness to accept the risk for abdominal morbidity or complications.

“Developing decision aids that elicit individual-level preferences and align patient values with treatment may provide an avenue to improve patient-centered care,” the authors write.

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