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Gepubliceerd in: Quality of Life Research 9/2017

10-04-2017

Making decisions about breast reconstruction: A systematic review of patient-reported factors influencing choice

Auteurs: Kathy Flitcroft, Meagan Brennan, Andrew Spillane

Gepubliceerd in: Quality of Life Research | Uitgave 9/2017

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Abstract

Purpose

Many studies have explored women’s reasons for choosing or declining a particular type of breast reconstruction (BR) following mastectomy for breast cancer. This systematic review synthesises women’s reasons for choosing a range of BR options, including no BR, in different settings and across time.

Methods

Thirteen databases were systematically searched, with 30 studies (4269 participants), meeting the selection criteria. Information on study aim and time frame, participation rate, design/methods, limitations/bias, reasons and conclusions, as well as participant clinical and demographic information, was reported. An overall quality score was generated for each study. Reasons were grouped into eight domains.

Results

While study methodology and results were heterogeneous, all reported reasons were covered by the eight domains: Feeling/looking normal; Feeling/looking good; Being practical; Influence of others; Relationship expectations; Fear; Timing; and Unnecessary. We found a strong consistency in reasons across studies, ranging from 52% of relevant publications citing relationship expectations as a reason for choosing BR, up to 91% citing fear as a reason for delaying or declining BR. Major thematic findings were a lack of adequate information about BR, lack of genuine choice for women and additional access limitations due to health system barriers.

Conclusions

Understanding women’s reasons for wanting or not wanting BR can assist clinicians to help women make choices most aligned with their individual values and needs. Our thematic findings have equity implications and illustrate the need for surgeons to discuss all clinically appropriate BR options with mastectomy patients, even if some options are not available locally.
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Metagegevens
Titel
Making decisions about breast reconstruction: A systematic review of patient-reported factors influencing choice
Auteurs
Kathy Flitcroft
Meagan Brennan
Andrew Spillane
Publicatiedatum
10-04-2017
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 9/2017
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-017-1555-z