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Patient Preferences in Access to Post-Mastectomy Breast Reconstruction
Christina R Vargas; Oren Ganor; Maria Semnack; Bernard T Lee
Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA

Background: There is currently considerable variability at our institution in the timing of consultation with a plastic and reconstructive surgeon following initial diagnosis of breast cancer and meeting with a breast surgeon, and no published data exists regarding what patients prefer. We aim to elucidate patients' preferences for the timing of plastic surgery consultation as part of the preoperative evaluation and planning process.

Methods: A 16-question electronic survey was developed using formative patient comments and discussion between the surgical teams. The survey was administered to all patients referred to the plastic and reconstructive surgery clinic to discuss immediate post-mastectomy breast reconstruction between December 2013 and July 2014.

Results: A total of 31 responses were collected during the study period. The largest number of patients (48%) indicated that they would prefer to see a plastic surgeon one week after the first consultation with a breast surgeon. Only one patient wanted to see both surgeons on the same day. Most patients indicated that having a family member or friend accompany them to the appointment (45%) and having time to process their cancer diagnosis before seeing the plastic surgeon (32%) were the key factors in deciding when they would like to discuss reconstruction.

Conclusion: The majority of patients in our study indicated a preference for delay between initial consultation with a breast surgeon and initial consultation with a plastic surgeon. Incorporating patient preferences into the preoperative evaluation and planning process allows patients to optimize available support from loved ones and to begin coping with their diagnosis.

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