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National study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates

BACKGROUND: Reconstructive alternatives should be discussed with women facing mastectomy for breast cancer. These include immediate and delayed reconstruction, which both have inherent advantages and disadvantages. Immediate reconstruction rates vary considerably in Swedish healthcare regions, and t...

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Autores principales: Frisell, A., Lagergren, J., de Boniface, J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095775/
https://www.ncbi.nlm.nih.gov/pubmed/27550796
http://dx.doi.org/10.1002/bjs.10286
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author Frisell, A.
Lagergren, J.
de Boniface, J.
author_facet Frisell, A.
Lagergren, J.
de Boniface, J.
author_sort Frisell, A.
collection PubMed
description BACKGROUND: Reconstructive alternatives should be discussed with women facing mastectomy for breast cancer. These include immediate and delayed reconstruction, which both have inherent advantages and disadvantages. Immediate reconstruction rates vary considerably in Swedish healthcare regions, and the aim of the study was to analyse reasons for this disparity. METHODS: All women who underwent mastectomy for primary breast cancer in Sweden in 2013 were included. Tumour data were retrieved from the Swedish National Breast Cancer Registry and from questionnaires regarding patient information and involvement in preoperative decision‐making sent to women who were still alive in 2015. RESULTS: Of 2929 women who had undergone 2996 mastectomies, 2906 were still alive. The questionnaire response rate was 76·3 per cent. Immediate reconstruction rates varied regionally, between 3·0 and 26·4 per cent. Tumour characteristics impacted on reconstruction rates but did not explain regional differences. Patient participation in decision‐making, availability of plastic surgery services and patient information, however, were independent predictors of immediate breast reconstruction, and varied significantly between regions. Even in younger patients with low‐risk tumours, rates of patient information ranged between 34·3 and 83·3 per cent. CONCLUSION: Significant regional differences in immediate reconstruction rates were not explained by differences in tumour characteristics, but by disparities in patient information, availability of plastic surgery services and involvement in decision‐making.
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spelling pubmed-50957752016-11-09 National study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates Frisell, A. Lagergren, J. de Boniface, J. Br J Surg Original Articles BACKGROUND: Reconstructive alternatives should be discussed with women facing mastectomy for breast cancer. These include immediate and delayed reconstruction, which both have inherent advantages and disadvantages. Immediate reconstruction rates vary considerably in Swedish healthcare regions, and the aim of the study was to analyse reasons for this disparity. METHODS: All women who underwent mastectomy for primary breast cancer in Sweden in 2013 were included. Tumour data were retrieved from the Swedish National Breast Cancer Registry and from questionnaires regarding patient information and involvement in preoperative decision‐making sent to women who were still alive in 2015. RESULTS: Of 2929 women who had undergone 2996 mastectomies, 2906 were still alive. The questionnaire response rate was 76·3 per cent. Immediate reconstruction rates varied regionally, between 3·0 and 26·4 per cent. Tumour characteristics impacted on reconstruction rates but did not explain regional differences. Patient participation in decision‐making, availability of plastic surgery services and patient information, however, were independent predictors of immediate breast reconstruction, and varied significantly between regions. Even in younger patients with low‐risk tumours, rates of patient information ranged between 34·3 and 83·3 per cent. CONCLUSION: Significant regional differences in immediate reconstruction rates were not explained by differences in tumour characteristics, but by disparities in patient information, availability of plastic surgery services and involvement in decision‐making. John Wiley & Sons, Ltd 2016-08-23 2016-11 /pmc/articles/PMC5095775/ /pubmed/27550796 http://dx.doi.org/10.1002/bjs.10286 Text en © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Frisell, A.
Lagergren, J.
de Boniface, J.
National study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates
title National study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates
title_full National study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates
title_fullStr National study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates
title_full_unstemmed National study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates
title_short National study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates
title_sort national study of the impact of patient information and involvement in decision‐making on immediate breast reconstruction rates
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095775/
https://www.ncbi.nlm.nih.gov/pubmed/27550796
http://dx.doi.org/10.1002/bjs.10286
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