Breast Reconstruction After Mastectomy: A Survey of Surgeons’ and Patients’ Perceptions

Ishak, Ariffuddin; Yahya, Maya Mazuwin; Halim, Ahmad Sukari

doi:10.1016/j.clbc.2018.04.012

Cited by 11 publications

(22 citation statements)

References 29 publications

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“…Surgeons might not recommend the surgery if they perceive that the patient cannot pay for the procedure or has inadequate knowledge of the operation. 7,8 In our case, we established that doctors perceived financial constraints to be a more significant barrier than what our patients perceive. Also, the surgeons were less likely to refer a patient for PMBR based on this.…”

Section: Discussionmentioning

confidence: 56%

“…6 Studies have shown that the negative predictive value of insufficient knowledge on PMBR has on the rate of PMBR. 4,5,7 We opine that when surgeons refer for the surgery, they fear that patients will not return to the hospital for delayed breast reconstruction due to insufficient knowledge and awareness of the procedure, as is the case in 62% of our patients. Our study established that plastic and reconstructive surgeons were more likely to view post-mastectomy patients as having insufficient knowledge pre-operatively on breast reconstruction options than their general surgeon counterparts.…”

Section: Discussionmentioning

confidence: 94%

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Doctor-patient perceptual differences to barriers to breast reconstruction at a tertiary public hospital in Kenya

Mwangi¹,

Ogalo²,

Kedera³

2021

MOJS

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Among women in Kenya, breast cancer has the highest incidence rate and prevalence rate. Despite the associated benefits of breast reconstruction in breast cancer care, most women usually do not have the surgery performed. We refer to either implant-based or autologous reconstruction of the breast, used separately or together for this study. 1 Gichuru et al., 2 noted a low rate of 2.9%. Patient-associated factors were noted as some of the causes of hindrances to this procedure. 2 Studies in our set-up have yet to explore the physician-associated factors. Stakeholders' perspectives on post-mastectomy breast reconstruction (PMBR) affect the procedure's uptake by patients considering it. 3 Lack of knowledge of PMBR contributes to its underperformance. Women require more opportunities to integrate and interpret information on their reconstructive options in shared decision making to allow for a more informed surgical treatment decision. 4,5 Referral propensity by surgeons predicts the occurrence of the procedure. [6][7][8] MethodsWe conducted a cross-sectional study via semi-structured questionnaires at the School of Medicine, University of Nairobi. The study population targeted opt-in general and plastics surgeons involved in patients' care of postmastectomy and mastectomy patients, n=312 as indicated in the Kenyatta National Hospital (KNH) registry. We included purposive sampling among surgeons. The surgeon had diverse postmastectomy breast reconstruction experiences, including no reconstruction working at the

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 94%

Doctor-patient perceptual differences to barriers to breast reconstruction at a tertiary public hospital in Kenya

Mwangi¹,

Ogalo²,

Kedera³

2021

MOJS

View full text Add to dashboard Cite

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“…This system had the advantage of different surgeons perform the best part of their work, however, some disadvantages remained unsolved [1]. For example, if the breast surgeons do not refer patients for breast reconstructions (as shown in Figure 3a), then patients may not have the chance to have breast-reconstruction consultations or operations provided by PS [20][21][22]. Sometimes, the BS or at the hospital just do not have adequate PS to perform the breast reconstructions [21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…Sometimes, the BS or at the hospital just do not have adequate PS to perform the breast reconstructions [21][22][23][24][25]. These were some of the reasons that breast reconstructions rate remained low (around 10-25%) around the world today [9,21,23,26].…”

Section: Discussionmentioning

confidence: 99%

“…For example, if the breast surgeons do not refer patients for breast reconstructions (as shown in Figure 3a), then patients may not have the chance to have breast-reconstruction consultations or operations provided by PS [20][21][22]. Sometimes, the BS or at the hospital just do not have adequate PS to perform the breast reconstructions [21][22][23][24][25]. These were some of the reasons that breast reconstructions rate remained low (around 10-25%) around the world today [9,21,23,26].…”

Section: Discussionmentioning

confidence: 99%

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Oncoplastic Reconstructive Breast Surgeon (ORBS) Performance and Impact on Breast Reconstructions: Clinical Outcome, Learning Curve, and Patient Reported Aesthetic Results- An analysis of 451 Procedures

Lai¹,

Lin²,

Chen³

et al. 2020

Preprint

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Oncoplastic and reconstructive breast surgeon (ORBS) aimed to incorporate aesthetics and plastic technique into breast cancer operations to balance the oncologic safety and cosmetic outcome, and also to promote breast reconstructions. The outcome of breast reconstruction performed by an ORBS was reported from a single institute. Among the 451 breast reconstructions performed by an ORBS, 75.8% were gel implant reconstructions, 3.3% were tissue expander, 16.9% were transverse rectus abdominal myocutaneous (TRAM) flap, 3.1% latissimus dorsi (LD) flap, and 0.9% LD flap + implant. The patients reported aesthetic evaluation showed that 53.9% responded excellent, 41.1% good, 4.4% fair, and 0.6% poor. In cumulative sum plot learning curve analysis, it took around 58 procedures for an ORBS to be familial with mastectomy followed by immediate gel implant reconstruction and to significantly decrease the operation time. In multivariate analysis, younger age, MRI, nipple sparing mastectomy, ORBS, and high-volume surgeon were factors related to breast reconstructions. Current study demonstrated that a breast surgeon after adequate training could become an ORBS and perform breast reconstructions with adequacy. Complimentary to traditional breast surgeon-to-plastic surgeon breast reconstruction pathways, ORBS could increase breast reconstructions rate, which remained low worldwide.

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ERAS for Breast Reconstruction

Temple‐Oberle

Webb

2020

Enhanced Recovery After Surgery

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Breast Reconstruction After Mastectomy: A Survey of Surgeons’ and Patients’ Perceptions

Cited by 11 publications

References 29 publications

Doctor-patient perceptual differences to barriers to breast reconstruction at a tertiary public hospital in Kenya

Doctor-patient perceptual differences to barriers to breast reconstruction at a tertiary public hospital in Kenya

Oncoplastic Reconstructive Breast Surgeon (ORBS) Performance and Impact on Breast Reconstructions: Clinical Outcome, Learning Curve, and Patient Reported Aesthetic Results- An analysis of 451 Procedures

ERAS for Breast Reconstruction

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