Measuring and managing patient expectations for breast reconstruction: impact on quality of life and patient satisfaction

Abstract

The goal of postmastectomy breast reconstruction is to restore a woman’s body image and to satisfy her personal expectations regarding the results of surgery. Studies in other surgical areas have shown that unrecognized or unfulfilled expectations may predict dissatisfaction more strongly than even the technical success of the surgery. Patient expectations play an especially critical role in elective procedures, such as cancer reconstruction, where the patient’s primary motivation is improved health-related quality of life. In breast reconstruction, assessment of patient expectations is therefore vital to optimal patient care. This report summarizes the existing literature on patient expectations regarding breast reconstruction, and provides a viewpoint on how this field can evolve. Specifically, we consider how systematic measurement and management of patient expectations may improve patient education, shared medical decision-making and patient perception of outcomes.

Keywords::

• breast cancer
• breast reconstruction
• expectations
• health-related quality of life
• patient education
• satisfaction

Financial & competing interests disclosure

Grant funding for the development of the BREAST-Q: Expectations for Reconstruction Module was provided by the National Endowment for Plastic Surgery and the NIH (R03 CA128476-01). The BREAST-Q is jointly owned by the Memorial Sloan–Kettering Cancer Center and the University of British Columbia. A Pusic, A Klassen and S Cano are codevelopers of the BREAST-Q and, as such, receive a share of any license revenues based on the inventor sharing policies of these two institutions. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.