Are Most Women Who Forgo Reconstruction After Mastectomy Satisfied With the Results?
Posted: Thursday, March 18, 2021
According to the results of a unique study presented in the Annals of Surgical Oncology, most women who choose not to undergo reconstruction surgery following mastectomy, known as “Going flat,” seem to be satisfied with the outcome. Deanna Attai, MD, of the University of California Los Angeles, and colleagues created the survey in concert with breast cancer advocates to ensure questions were not unintentionally biased toward reconstruction. Surveys such as BREAST-Q, which reported low satisfaction among the going flat community, have been criticized for containing such bias.
“We hope that the results of this study will serve to inform general and breast surgeons that going flat is a valid option for patients, and one that needs to be offered as an option,” noted Dr. Attai in a UCLA Health press release.
The online survey, available between October 15 and October 21, 2019, had 931 respondents. Participants had a history of or elevated risk for breast cancer and had undergone unilateral or bilateral mastectomy; they had not received breast mound reconstruction at the time of survey completion. A total of 73.7% of participants indicated that forgoing reconstructive surgery after mastectomy was their first choice of treatment. The two most common reasons for choosing this option were prioritizing a faster recovery and wanting to avoid the addition of foreign bodies.
The majority of participants were satisfied with their outcome, with a mean scaled satisfaction score of 3.72 ± 1.17 out of 5. Adequate patient education regarding surgical options and the provision of care by a surgeon who specializes in breast surgery were predictors of satisfaction, whereas lack of surgeon support for the decision and a patient body mass index of 30 kg/m2 or higher were predictors of dissatisfaction. “Flat denial” was an issue for 22% of patients, who had either not been offered the initial opportunity to go flat, not experienced surgeon support, or been left with additional unwanted skin after surgery to facilitate reconstruction should they later change their minds.
Disclosure: The study authors reported no conflicts of interest.