Women's satisfaction with breast reconstruction after mastectomy and a survey on the decision process for type of reconstructive surgery

Background Breast reconstruction is an option for women after breast cancer surgery to improve the quality of life. While data about satisfaction after reconstruction are available, little is known about the decision process and about factors shaping this process. Methods From 100 selected women, 72 women between 30 and 65 years of age (median 50.3 years, interquartile range 44-57 years) with breast reconstruction conducted in a single center in Vienna (Austria) consented to take part in this study. The role of family, social environment and healthcare providers during decision making, body image, thoughts about hospital stay and potential complications were assessed by a questionnaire. The decision for autologous tissue versus silicone implants was analyzed by structural equation modelling. Results Overall, 69% of the women chose autologous tissue either alone or in combination with a silicone prosthesis. Visual appearance was the most important reason (86%) for choosing reconstruction. Thoughts about the stay in hospital and possible complications were important for the mediating role of healthcare providers in deciding on the type of reconstruction. If women had no concerns about complications they made the choice on their own and favoring autologous tissue reconstruction. In contrast, if such concerns existed women tended to seek help from healthcare providers and tended to choose silicone implants. Conclusion Counselling of women after breast cancer surgery and during decision making for breast reconstruction should include an esthetic outcome but also possible complications and related length of hospital stay.