title: Can specific preoperative counseling increase the likelihood a woman will choose postmastectomy breast reconstruction?
abstract: BACKGROUND
  Low reconstruction rates after mastectomy for breast cancer raise questions about the impact of preoperative education. This study determines whether counseling about reconstruction influences the decision about reconstruction.
  
  
  METHODS
  The study was based on a prospectively collected database of breast cancer surgery.
  
  
  RESULTS
  A total of 299 operations for breast cancer were performed. Of 127 mastectomies, 21 (16%) were not candidates. In all, 106 women were specifically educated about reconstruction; 40 (37%) women consulted with a plastic surgeon; and 22 (21%) women ultimately chose reconstruction. Forty women had the option of mastectomy or breast conservation. Twelve (30%) women accepted a consultation with a plastic surgeon. Six of these women (15%) ultimately chose reconstruction. Mastectomy was required in 66 women; 28 (42%) accepted a consultation with a plastic surgeon; 16 (24%) underwent reconstruction; 3 additional women are planning delayed reconstruction (28%).
  
  
  CONCLUSIONS
  Reconstruction is more likely when mastectomy is required than when it is chosen. Low reconstruction rates reflect patient desire rather than access or education.
authors.affiliation: Department of Surgery, University of Colorado Health Science Center, 4200 E. Ninth Ave., Box C-311, Denver, CO 80262, USA. Christina.Finlayson@UCHSC.edu
authors.forename: C A
authors.initials: CA
authors.lastname: Finlayson
authors.forename: T A
authors.initials: TA
authors.lastname: MacDermott
authors.forename: J
authors.initials: J
authors.lastname: Arya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery; D003376:Counseling; D003657:Decision Making; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D008408:Mastectomy; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011300:Preoperative Care; D011446:Prospective Studies