Key factors in the decision-making process for mastectomy alone or breast reconstruction: A qualitative analysis
Breast cancer is the most common cancer to affect New Zealand women. Women diagnosed face several decisions regarding surgical treatment, including whether to undergo lumpectomy, mastectomy, or breast reconstruction. Reconstructive surgery adds an additional layer of complexity, with several reconst...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977623007269 |
| _version_ | 1797296201724329984 |
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| author | T. Blackmore K. Norman V. Burrett J. Scarlet I. Campbell R. Lawrenson |
| author_facet | T. Blackmore K. Norman V. Burrett J. Scarlet I. Campbell R. Lawrenson |
| author_sort | T. Blackmore |
| collection | DOAJ |
| description | Breast cancer is the most common cancer to affect New Zealand women. Women diagnosed face several decisions regarding surgical treatment, including whether to undergo lumpectomy, mastectomy, or breast reconstruction. Reconstructive surgery adds an additional layer of complexity, with several reconstructive options, each associated with differing surgical and recovery times. Furthermore, surgical decisions are often made under time-pressure and significant diagnostic distress, therefore provision of good information to support decision-making is crucial to adequately inform women of their options. We interviewed 24 women who had undergone breast surgery within the preceding 12 months to assess the key factors leading to their decision to opt for their chosen surgical procedure. Interviews revealed that decision-making was complex and involved multiple factors. Women were ultimately confronted with assessing feminine identity versus survival. Whether opting for breast reconstruction or not, women were fearful of what surgery would involve and how their reconstructed breast or mastectomy scar might look following surgery. Shared decision-making between patient and clinician can mitigate this fear and provide women with a sense of autonomy over their health decisions. Provision of visual depictions of surgical outcomes was not routinely provided to those interviewed but was expressed as important to help women manage surgical expectations. Therefore our findings support the multi-modal presentation of diagnostic and treatment information to support decision-making. Likewise, women reported feeling unsupported in their decision not to undergo breast reconstruction, suggesting a need to develop resources to provide women with positive discussions about ‘going flat’. |
| first_indexed | 2024-03-07T22:01:03Z |
| format | Article |
| id | doaj.art-4e1e4c5660e24da79acf9a9f362dea7d |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-03-07T22:01:03Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-4e1e4c5660e24da79acf9a9f362dea7d2024-02-24T04:54:27ZengElsevierBreast1532-30802024-02-0173103600Key factors in the decision-making process for mastectomy alone or breast reconstruction: A qualitative analysisT. Blackmore0K. Norman1V. Burrett2J. Scarlet3I. Campbell4R. Lawrenson5Te Kura Whatu Oho Mauri - School of Psychology, University of Waikato, Private Bag 3105, Hamilton, 3240, New Zealand; Corresponding author.Te Huataki Waiora – School of Health, University of Waikato, Hamilton, New ZealandCancer Psychological and Social Supportive Service, Te Whatu Ora – Health New Zealand, Waikato, New ZealandBreast Care Centre, Te Whatu Ora – Health New Zealand Waikato, New ZealandBreast Care Centre, Te Whatu Ora – Health New Zealand Waikato, New ZealandTe Huataki Waiora – School of Health, University of Waikato, Hamilton, New ZealandBreast cancer is the most common cancer to affect New Zealand women. Women diagnosed face several decisions regarding surgical treatment, including whether to undergo lumpectomy, mastectomy, or breast reconstruction. Reconstructive surgery adds an additional layer of complexity, with several reconstructive options, each associated with differing surgical and recovery times. Furthermore, surgical decisions are often made under time-pressure and significant diagnostic distress, therefore provision of good information to support decision-making is crucial to adequately inform women of their options. We interviewed 24 women who had undergone breast surgery within the preceding 12 months to assess the key factors leading to their decision to opt for their chosen surgical procedure. Interviews revealed that decision-making was complex and involved multiple factors. Women were ultimately confronted with assessing feminine identity versus survival. Whether opting for breast reconstruction or not, women were fearful of what surgery would involve and how their reconstructed breast or mastectomy scar might look following surgery. Shared decision-making between patient and clinician can mitigate this fear and provide women with a sense of autonomy over their health decisions. Provision of visual depictions of surgical outcomes was not routinely provided to those interviewed but was expressed as important to help women manage surgical expectations. Therefore our findings support the multi-modal presentation of diagnostic and treatment information to support decision-making. Likewise, women reported feeling unsupported in their decision not to undergo breast reconstruction, suggesting a need to develop resources to provide women with positive discussions about ‘going flat’.http://www.sciencedirect.com/science/article/pii/S0960977623007269Breast cancerBreast reconstructionSurgeryShared decision-makingInformation needs |
| spellingShingle | T. Blackmore K. Norman V. Burrett J. Scarlet I. Campbell R. Lawrenson Key factors in the decision-making process for mastectomy alone or breast reconstruction: A qualitative analysis Breast Breast cancer Breast reconstruction Surgery Shared decision-making Information needs |
| title | Key factors in the decision-making process for mastectomy alone or breast reconstruction: A qualitative analysis |
| title_full | Key factors in the decision-making process for mastectomy alone or breast reconstruction: A qualitative analysis |
| title_fullStr | Key factors in the decision-making process for mastectomy alone or breast reconstruction: A qualitative analysis |
| title_full_unstemmed | Key factors in the decision-making process for mastectomy alone or breast reconstruction: A qualitative analysis |
| title_short | Key factors in the decision-making process for mastectomy alone or breast reconstruction: A qualitative analysis |
| title_sort | key factors in the decision making process for mastectomy alone or breast reconstruction a qualitative analysis |
| topic | Breast cancer Breast reconstruction Surgery Shared decision-making Information needs |
| url | http://www.sciencedirect.com/science/article/pii/S0960977623007269 |
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