Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception

Background Breast reconstruction post-mastectomy is important in breast cancer care. Methodology A cross-sectional study was designed to assess surgeons’ and patients’ perceptions towards breast reconstruction. Questionnaires were distributed to all general and breast surgeons in East Coast Mal...

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Main Author:	Ishak, Ariffuddin
Format:	Thesis
Language:	English
Published:	2018
Subjects:	RG Gynecology and obstetrics
Online Access:	http://eprints.usm.my/45820/1/Dr.%20Ariffuddin%20Ishak-24%20pages.pdf
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spelling	my-usm-ep.458202019-12-04T08:17:12Z Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception 2018 Ishak, Ariffuddin RG Gynecology and obstetrics Background Breast reconstruction post-mastectomy is important in breast cancer care. Methodology A cross-sectional study was designed to assess surgeons’ and patients’ perceptions towards breast reconstruction. Questionnaires were distributed to all general and breast surgeons in East Coast Malaysia’s general and teaching hospitals and Hospital Kuala Lumpur (n=40), post-mastectomy patients with (n=66) and without breast reconstruction (n=291) from Hospital Universiti Sains Malaysia (HUSM) and Hospital Raja Perempuan Zainab II (HRPZ II). Response rates were 82.5% surgeons (n=33), 95.4% patients with reconstruction (n=63) and 95.5% patients without reconstruction (n=278). Result Data from 30 surgeons (3 excluded as 1 surgeon no longer treating breast diseases and 2 incomplete responses) showed median age of 42 years with 6 years’ experience. Each surgeon saw average 20 new breast cancer cases a year. Most surgeons (86.7%) discussed reconstruction option with patients. However, referral rate was low whereby each surgeon referred only average 4 cases for reconstruction over 3 years. Surgeons’ concern on qualitative outcome increases the likelihood of discussion regarding breast reconstruction with patients (B=4.833, p=0.044). Data from 302 patients (39 exclusion for incomplete responses) showed women with reconstruction were younger (mean age 42 vs 50 years), more were working (69.4% vs 42.2%) and have prior awareness (90.3% vs 44.3%) compared to non-reconstruction group. Commonest reasons for having reconstruction were ‘to feel more balanced’ (92.1%) and ‘surgeon’s strong recommendation’ (92.1%). Prior knowledge on breast reconstruction increases likelihood of reconstruction (OR:5.805, p=0.026). While no surgeons have concern on reconstructive surgery outcome, 21.8% patients were unimpressed with previous outcome seen. Although 70% surgeons felt that patients may not be interested in reconstruction, only 37.9% patients with prior awareness claim to have no interest. Conclusion The study’s low reconstruction rate (20.6%) may be attributed to low referral. Surgeons’ hypothetical criticisms may play some role in the referral rate. Patients’ likelihood to undergo reconstruction with surgeons’ recommendation and prior awareness were reflective of surgeons’ strong influence on patient. Thus clarification on surgeons’ hypothetical criticisms may conceivably increase the reconstructive surgery rate. 2018 Thesis http://eprints.usm.my/45820/ http://eprints.usm.my/45820/1/Dr.%20Ariffuddin%20Ishak-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RG Gynecology and obstetrics
spellingShingle	RG Gynecology and obstetrics Ishak, Ariffuddin Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception
description	Background Breast reconstruction post-mastectomy is important in breast cancer care. Methodology A cross-sectional study was designed to assess surgeons’ and patients’ perceptions towards breast reconstruction. Questionnaires were distributed to all general and breast surgeons in East Coast Malaysia’s general and teaching hospitals and Hospital Kuala Lumpur (n=40), post-mastectomy patients with (n=66) and without breast reconstruction (n=291) from Hospital Universiti Sains Malaysia (HUSM) and Hospital Raja Perempuan Zainab II (HRPZ II). Response rates were 82.5% surgeons (n=33), 95.4% patients with reconstruction (n=63) and 95.5% patients without reconstruction (n=278). Result Data from 30 surgeons (3 excluded as 1 surgeon no longer treating breast diseases and 2 incomplete responses) showed median age of 42 years with 6 years’ experience. Each surgeon saw average 20 new breast cancer cases a year. Most surgeons (86.7%) discussed reconstruction option with patients. However, referral rate was low whereby each surgeon referred only average 4 cases for reconstruction over 3 years. Surgeons’ concern on qualitative outcome increases the likelihood of discussion regarding breast reconstruction with patients (B=4.833, p=0.044). Data from 302 patients (39 exclusion for incomplete responses) showed women with reconstruction were younger (mean age 42 vs 50 years), more were working (69.4% vs 42.2%) and have prior awareness (90.3% vs 44.3%) compared to non-reconstruction group. Commonest reasons for having reconstruction were ‘to feel more balanced’ (92.1%) and ‘surgeon’s strong recommendation’ (92.1%). Prior knowledge on breast reconstruction increases likelihood of reconstruction (OR:5.805, p=0.026). While no surgeons have concern on reconstructive surgery outcome, 21.8% patients were unimpressed with previous outcome seen. Although 70% surgeons felt that patients may not be interested in reconstruction, only 37.9% patients with prior awareness claim to have no interest. Conclusion The study’s low reconstruction rate (20.6%) may be attributed to low referral. Surgeons’ hypothetical criticisms may play some role in the referral rate. Patients’ likelihood to undergo reconstruction with surgeons’ recommendation and prior awareness were reflective of surgeons’ strong influence on patient. Thus clarification on surgeons’ hypothetical criticisms may conceivably increase the reconstructive surgery rate.
format	Thesis
qualification_level	Master's degree
author	Ishak, Ariffuddin
author_facet	Ishak, Ariffuddin
author_sort	Ishak, Ariffuddin
title	Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception
title_short	Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception
title_full	Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception
title_fullStr	Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception
title_full_unstemmed	Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception
title_sort	breast reconstruction after mastectomy : a survey of surgeons' and patients' perception
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2018
url	http://eprints.usm.my/45820/1/Dr.%20Ariffuddin%20Ishak-24%20pages.pdf
_version_	1747821574205997056

Breast reconstruction after mastectomy : a survey of surgeons' and patients' perception

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