Health
Studies show that an increasing number of women are accepting to “flatten” after a mastectomy
A study led by researchers at the UCLA Jonsson Comprehensive Cancer Center found that an increasing number of women are refraining from reconstruction after a mastectomy and are happy with their choices, even if they don’t feel the support of a doctor. I will.
Studies published in the journal Annual Report of Surgical OncologyInvestigate 931 women who underwent unilateral or bilateral mastectomy without current breast mound reconstruction, assess motivational factors to discontinue the procedure, and appropriate for surgeons to “flatten” We measured whether we provided information and support.
Of the women surveyed, 74% were satisfied with the results and 22% experienced a “flat refusal.” In this case, the procedure was not initially provided, the surgeon did not support the patient’s decision, or intentionally left additional skin in case the patient changed her mind.
The team also investigated the reasons for the choice and noted that women wanted the belief that faster recovery, avoidance of foreign body placement, and reconstruction of the breast mound were not important to body image.
“Being a mastectomy with or without reconstruction is often a very personal choice,” said Dr. Deanna Attai, an assistant professor of surgery at UCLA’s David Geffen School of Medicine and a senior author of the study. “For some women,” flattening “is a desirable and deliberate option, should be supported by the treatment team, and means that women who forget to reconstruct are not interested in their postoperative appearance. It turned out that it was not a thing. “
The results disagree with previous studies showing that patients who choose not to undergo breast reconstruction tend to have a lower quality of life than those who have had surgery.
Attai and her team found that the majority of patients who chose to be flat were actually happy with their surgical results. The authors believe that the research tools commonly used to evaluate results are biased towards reconstruction. To avoid that prejudice, Attai worked with patient advocates to develop a unique study to assess the reasons for punctures, satisfaction with their decisions, and factors related to satisfaction. They also identified concerns specific to these patients that were not captured in other validated studies.
The majority of the women surveyed reported that they were satisfied with the results of the surgery, but 27% of the patients surveyed reported that they were not satisfied with the appearance of the chest wall.
“Some patients intentionally leave extra skin in spite of a preoperative agreement to close the chest wall flat for use in future reconstruction in case the patient changes his mind. I was told, “said UCLA Johnson General Cancer Center. “I was surprised that some women had to struggle to get the treatment they wanted.”
Surgeons may hesitate to recommend a mastectomy without a reconstructive surgeon because they are not confident that they can provide cosmetically acceptable results to patients who desire a flat chest wall, Attai said.
“We hope that the results of this study will help general surgeons and breast surgeons know that flattening is a valid option for patients and needs to be offered as an option,” Attai said. Stated. “We also hope that the results will inform patients that flattening is an option, provide this option, and help give patients the power to find surgeons who respect their decisions.”
Source:
Journal reference:
Baker, JL, et al. (2021) “Flat” after mastectomy: Results of patient reports from online surveys. Annual report of surgical oncology. doi.org/10.1245/s10434-020-09448-9..
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