Disparities examined in perceptions of breast reconstruction outcomes
Shannon S. Wu, from the Cleveland Clinic, and colleagues studied factors associated with the disparity between patient and observer perceptions of outcomes of breast reconstruction. The analysis included 147 patients who underwent breast reconstruction (2009 to 2011) and completed the BREAST-Q. Photographs were graded by a diverse panel using the Validated Breast Aesthetic Scale.
The researchers found that 19 percent of patients were categorized as having patient satisfaction that exceeded observer scores (group 1), 63 percent with alignment between patient satisfaction and observer scores (group 2), and 18 percent with patient satisfaction lower than observer scores (group 3). Group 3 had the highest median overall appearance, and group 1 had the lowest. Group 1 and 3 status were significantly associated with psychosocial, sexual, and physical well-being. Age, body mass index, autologous or implant-based, adjuvant therapies, and timing of reconstruction were not significantly associated with disparity.
“Our results impact shared decision making between patient and physician in the preoperative planning stages,” the authors write. “Evaluation of a patient with low baseline psychosocial, sexual, or physical functioning, or evidence to suggest future impairments, may warrant further discussion about expectations of postoperative outcomes.”