Perception critical to women's breast reconstruction decision making

February 18, 2021

When women undergo surgical treatment for breast cancer, they often also have reconstructive surgery but new QUT research reveals many women feel left out of the decision making.

An interdisciplinary study from researchers in QUT's Centre for Behavioural Economics, Society and Technology (BEST), Engineering Faculty, and School of Nursing, along with Dr Jeremy Hunt a Fellow of the Royal Australasian College of Surgeons and Dr Tim Peltz from the University of New South Wales, on Knowledge, consultation time and choice in breast reconstruction has just been published in the British Journal of Surgery.

"Approximately one in seven Australian women will be diagnosed with breast cancer in their lifetime," said QUT behavioural economist Dr Stephen Whyte.

"Because the decision-making process in any surgical procedure is clearly influenced by the recommendations of doctors, patient-clinician trust is critical in the lead up to the postmastectomy breast reconstruction decision.

"Yet there are very few metrics available which analyse the duration of consultation between surgeons, nurses, and patients, and particularly how patients perceive and are influenced by the expert knowledge they are provided."

Distinguished Professor Dietmar W. Hutmacher said the research was the largest ever behavioural study of breast surgeons, breast care nurses and former or current breast cancer patients.

"We surveyed 53 specialist surgeons, 101 breast care nurses and 689 former or current breast cancer patients seeking data relating to the number of minutes spent in first consultation, the level of knowledge of the individuals involved, and the level of involvement of each party in the final therapy choice," Professor Hutmacher said.

"Interestingly, we found that in our sample breast care nurses and surgeons have quite different perceptions of how much time the other spends engaging the patient at their first consultation. Each thought that they spent more time with patients than the other.

"And as for the patients, approximately one in every three women (32%) stated their surgeon had more input than they did, when deciding which type of breast reconstruction to undergo."

Dr Whyte added that around 16% of the women in the study said they had zero input into the type of breast reconstruction they chose.

He said the perceptions of individuals about an experience or interaction can differ significantly, particularly in high stress environments, which can become problematic because our perceptions inform our expectations.

"When it came to the choice of breast reconstruction, our study revealed a large proportion of women who felt or believed that their surgeon effectively made a decision on their behalf when it came to their reconstruction," Dr Whyte said.

"This finding raises concerns in relation to not only informed consent prior to surgery, but more importantly patient expectations ex-poste surgery."

Dr Whyte added that research has shown a more patient centric preoperative information and surgeon interaction significantly influence patient satisfaction post breast reconstruction. So, understanding how surgeons, nurses and patients interact and communicate is of critical importance for effective health care provision and patient satisfaction.

"The study's findings underscore the critical nature of developing new and better tools for effective communication between patients and medical professionals to facilitate the best possible outcomes regarding elective medical procedures," he said.

Participants in the survey were recruited from Breast Cancer Network Australia's Review and Survey Group, a national, online group of Australian women living with breast cancer who are interested in receiving invitations to participate in research. The researchers also collaborated with the Australian Society of Aesthetic Plastic Surgeons, the Australian Society of Plastic Surgeons, Breast Cancer Network Australia, Breast Wishes Journey, Cancer Nurses Society of Australia, the McGrath Foundation, and Dragon Abreast Australia.
-end-
A PDF of the research findings is available.

Media contact: Amanda Weaver, QUT Media, 07 3138 3151, amanda.weaver@qut.edu.au

After hours: Rose Trapnell, 0407 585 901, media@qut.edu.au



Queensland University of Technology

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.