Patients Choose against Reconstruction after Mastectomy for Breast Cancer. Do Women Disregard the Quality of Their Future Life?

Material and method. A series of 63 patients were evaluated for their perception regarding breast reconstruction. We used a two step evaluation based on an interview. Results. In preoperative stage 45% of patients agree with reconstruction. Patients tend to be reserved postoperatively. Correlation with age shows a statistically significant association between age-groups and agreement with reconstruction (p=0.004). Women choose in favor of reconstruction in order to regain womanhood (67% preoperative, 59% postoperative), emotional balance (67% preoperative, 51% postoperative), and less for their partners or sexual life (21% preoperative, 12% postoperative). Reconstruction looses significance after the operation (46% agreement versus 20% agreement), but a strong recommendation from the surgeon represents a major argument (54% preoperative, 45% postoperative). The surgeon’s advice against reconstruction will negatively influence decision (87% preoperative versus 84% postoperative agree with the surgeon’s suggestion). 83% cases in preoperative stage, 79% in postoperative stage will consider the price as an argument against reconstruction. Other reasons against reconstruction are fear for more surgical procedures, complications and need for adjuvant therapy. Conclusions. Breast reconstruction is not widely accepted. The lack of information regarding reconstruction and the financial implications are obvious. The surgeon’s opinion has a major influence and we should consider women with breast cancer as a vulnerable population in need for better information related to reconstruction after mastectomy.