What Does “Dr. Google” Show Patients Searching for Breast Reconstruction Outcomes Photographs?

Abstract

Background: Many women with breast cancer search the internet for photographs of their potential reconstruction outcomes, but little is known about the quality, variety, and relevance of images patients are viewing. Methods: Breast reconstruction outcome photographs identified by a Google Images search were assessed based on the American Society of Plastic Surgeons/Plastic Surgery Foundation photographic guidelines. Information such as source metadata, breast reconstruction procedure information, and subject demographics was collected from the photographs. Additional analyses were conducted to assess whether nipple reconstruction or tattooing occurred and was disclosed, whether a symmetry procedure was performed and disclosed, and whether donor site scarring is visible in abdominal flap photographs. Results: We acquired and analyzed 114 photograph sets. Although a variety of images were readily available, the majority of photograph sets did not follow photographic guidelines or provide sufficient information. Most photograph sets (60%) indicated symmetry procedures when a symmetry procedure was evident, but only 40% of photograph sets disclosed a nipple procedure when a nipple procedure was evident. Only 40% of abdominal flap photographs showed donor site scarring. Subject demographics were largely missing: 50% of photograph sets included subject age, 3% included race or ethnicity, and 12% included weight or BMI. Conclusions: Although breast reconstruction outcome photographs shown by “Dr. Google” represent a variety of reconstruction types, they typically lack information that a patient needs to assess self-applicability. Patients may benefit from discussion with their healthcare team about the strengths and limitations of breast reconstruction outcome photographs available on the internet.

Breast Decisions: Recommender System for Appearance Counseling about Breast Reconstruction

“…While pooling photographs across surgeons is not ideal, it may be better for a patient to view photographs from other practices that their surgeon deems as similar to their own rather than relying only on photographs from sources outside of their surgeon's control, for example, photographs that a patient finds on the internet. 23 A larger knowledgebase also allows for more specific filters, which may be desirable for certain appearance counseling scenarios, such as viewing photographs at home. Feasibility of implementing the BreastDecisions system will depend upon the appearance counseling scenario and the systems already in place at a particular institution.…”