Choices and information offered to patients undergoing immediate post-mastectomy breast reconstruction: a survey of patient opinion and self-assessed outcome

For those patients who request breast reconstruction after mastectomy, the immediate procedure is becoming increasingly common. Whilst this option results in resource cost savings, and may have benefits for patients, little is known about the information offered to patients who are faced with a mastectomy/reconstruction decision. To investigate these concerns, and also to determine patientsʹ own assessment of their outcome after immediate reconstruction, we carried out a retrospective survey of all patients who underwent an immediate breast reconstruction at this Centre over a 3-year period, utilizing a detailed study-specific questionnaire, together with two widely used health status instruments. The response rate was 92% (57 patients). Nearly all patients were found to have been offered the choice of a delayed procedure, should they wish it, but information about type and choice of prosthesis was considered by patients to be inadequate. Steps to address this have been implemented. Scores from the SF-36 Health Survey Questionnaire showed that this patient group was comparable with a normal female population for the dimensions of physical function, mental health, energy, and general health. However, social function was found to be significantly lower, and a substantial minority (46%) exhibited some anxiety as assessed by the Hospital Anxiety and Depression (HAD) Scale.