Receipt of delayed breast reconstruction after mastectomy: do XXXX revisit the decision?

@entity5 @entity1 @entity0
BACKGROUND: Postmastectomy breast reconstruction is an important component of @entity0 care, but few receive it at the time of the mastectomy. Virtually nothing is known about receipt of reconstruction after initial @entity5 therapy and why treatment might be delayed. MATERIALS AND METHODS: A 5-year follow-up survey was mailed to a population-based cohort of mastectomy-treated @entity0 @entity1 who were initially surveyed at time of diagnosis in 2002 and reported to the Los Angeles and Detroit SEER registries (N  =  645, response rate 60%). Outcomes were receipt of reconstruction (immediate [IR], delayed [DR], or none) and @entity1 appraisal of their treatment decisions. RESULTS: About one-third (35.9%) had IR, 11.5% had DR, and 52.6% had no reconstruction. One-third delayed reconstruction because they focused more on other @entity5 interventions, and nearly half were concerned about surgical complications and interference with @entity5 surveillance. Two-thirds of those with no reconstruction said that the procedure was not important to them. A large proportion of all @entity1 were satisfied with their reconstruction decision-making (89.4% IR, 78.4% DR, 80.4% no reconstruction, P  =  NS). However, only 59.3% of those with no reconstruction felt that they were adequately informed about their reconstructive options (vs 82.7% IR and 78.4% DR, P  <  .01). CONCLUSIONS: There was modest uptake of breast reconstruction after initial @entity5 treatment. Factors associated with delayed reconstruction were primarily related to uncertainty about the procedure, concern about @entity5 surveillance, and low priority. Those without reconstruction demonstrated significant informational needs, which should be addressed with future research efforts.
