The DOI matches its Crossref record; 7 of the 7 references it cites were found in a registry or an index.
Do Patients and Providers Agree About the Most Important Facts and Goals for Breast Reconstruction Decisions?
Abstract
UNLABELLED: Decisions about breast reconstruction after mastectomy are some of the most difficult decisions a breast cancer patient makes. To make a good decision, the patient should have adequate knowledge of specific facts related to the decision, and the treatment chosen should be consistent with the patient's personal preferences or goals. We sought to identify the most important facts and goals for decisions about breast reconstruction after mastectomy, and to compare patients' and providers' perspectives. We conducted a cross-sectional survey of breast cancer survivors and providers. Participants rated and ranked the importance of facts and goals/concerns related to breast reconstruction after mastectomy. We compared patients' and providers' rankings using chi2 tests and compared ratings using t-tests. About 21 patients and 20 providers participated. Facts: Providers were more concerned about the impact of radiation on the success of the reconstruction than patients (60% vs. 24%, 95% CI of the difference: -64, -8). Thirty percent of providers placed the fact that women who do not have reconstruction are equally satisfied as women who have reconstruction in the top 3, whereas almost no patients did (30% vs. 5%, 95% CI: -47, -3). For all 3 of the facts about immediate versus delayed reconstruction, women placed a higher priority on these facts than providers did. GOALS: Patients placed greater importance on avoiding use of a prosthesis (33% vs. 0%, 95% CI of the difference: 13, 54). There was a trend toward less patient concern about "looking natural without clothes" compared to providers (24% vs. 40%, 95% CI of the difference: -12, 44). Significant variability exists among patients and between patients and providers, with respect to the most important facts and goals to guide decision making about reconstruction. Providers should ensure that women understand that reconstruction can be performed immediately or delayed, as well as the likelihood and type of complications. Surgeons should ask each woman which goals and concerns are most important to her. Specifically, they should inquire as to how women feel about using a prosthesis, and how they feel about their appearance with and without clothes.
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“The inability of clinicians, patients, and caregivers to predict each other’s preferences is also reported in the treatment decision making literature [7, 37–39].”
From Development of a decision guide to support the elderly in decision making about location of care: an iterative, user-centered design (2016) · cites this paper as [39]
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Cites
Alderman, A. K., Wilkins, E. G., Kim, H. M., & Lowery, J. C. (2002) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-200206000-00015 · Cited by 603
Harcourt, D. M., Rumsey, N., Ambler, N., Cawthorn, S., Reid, C. D., Maddox, P. R., Kenealy, J., Rainsbury, R., & Umpleby, H. C. (2003) · Plastic & Reconstructive Surgery · doi:10.1097/01.prs.0000046249.33122.76 · Cited by 308
An approach to measuring the quality of breast cancer decisions
Sepucha, K., Ozanne, E. M., Silvia, K. A., Partridge, A. H., & Mulley, A. G. (2006) · Patient Education and Counseling · doi:10.1016/j.pec.2006.08.007 · Cited by 154
Self-citationCorrelates of breast reconstruction
Morrow, M., Mujahid, M. S., Lantz, P. M., Janz, N. K., Fagerlin, A., Schwartz, K., Liu, L., Deapen, D., Salem, B., Lakhani, I., et al. (2005) · Cancer · doi:10.1002/cncr.21444 · Cited by 135
Abu-Nab, Z., & Grunfeld, E. A. (2007) · Patient Education and Counseling · doi:10.1016/j.pec.2006.12.008 · Cited by 65
Variation in Physician-patient Discussion of Breast Reconstruction
Chen, J. Y., Malin, J., Ganz, P., Ko, C. Y., Tisnado, D., Tao, M., Timmer, M. J., Adams, J. L., & Kahn, K. (2008) · Journal of general internal medicine · doi:10.1007/s11606-008-0855-y · Cited by 44
Shakespeare, V. A., & Hobby, J. (2001) · The Breast · doi:10.1054/brst.2001.0309 · Cited by 13
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Stop the silent misdiagnosis: patients' preferences matter
Mulley, A. G., Trimble, C., & Elwyn, G. J. (2012) · BMJ · doi:10.1136/bmj.e6572 · Cited by 639
Patient-centered care: achieving higher quality by designing care through the patient’s eyes
Edgman‐Levitan, S., & Schoenbaum, S. C. (2021) · Israel Journal of Health Policy Research · doi:10.1186/s13584-021-00459-9 · Cited by 246
US Preventive Services Task Force, Davidson, K. W., Mangione, C. M., Barry, M. J., Nicholson, W. K., Cabana, M. D., Caughey, A. B., Davis, E. M., Donahue, K. E., Doubeni, C. A., et al. (2022) · JAMA · doi:10.1001/jama.2022.3267 · Cited by 173
Hallberg, H., Rafnsdóttir, S., Selvaggi, G., Strandell, A., Samuelsson, O. G., Stadig, I., Svanberg, T., Hansson, E., & Lewin, R. (2018) · Journal of Plastic Surgery and Hand Surgery · doi:10.1080/2000656x.2017.1419141 · Cited by 134
Shared decision making in endocrinology: Present and future directions
Rodriguez-Gutierrez, R., Gionfriddo, M. R., Ospina, N. S., Maraka, S., Tamhane, S., Montori, V. M., & Brito, J. P. (2016) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00468-4 · Cited by 117
Metadata
- Authors
- Lee, C. N., Hultman, C. S., & Sepucha, K.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Harvard University (US)
- Corresponding author
- Lee, Clara N.
- Hultman, C Scott
- Venue
- Annals of Plastic Surgery
- Published
- 2010-05
- Volume
- 64
- Issue
- 5
- Pages
- 563-566
- ISSN
- 0148-7043 (ISSN-L)
- OpenAlex
- W1972906878
- Cited by
- 74
- References
- 7
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 8 · 2022: 5 · 2021: 10 · 2020: 4 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 8 · 2015: 5 · 2014: 5 · 2013: 4 · 2012: 2
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Plastic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (KL2RR025746)
- Topics
- Health Sciences › Medicine › Surgery › Breast Implant and Reconstruction
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- breast reconstruction, breast cancer, mastectomy, shared decision-making, patient-provider agreement, patient preferences, prosthesis, patient satisfaction, breast cancer survivors
- MeSH terms
- Breast Neoplasms, Cross-Sectional Studies, Decision Making, Esthetics, Female, Goals, Humans, Mastectomy, Physician-Patient Relations, Postoperative Complications, Risk Factors, Chi-Square Distribution, Mammaplasty, Survivors
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