title: Perspective on reconstruction after mastectomy.
abstract: BACKGROUND
  We sought to evaluate the factors influencing our patients to receive or forego reconstruction after mastectomy and their subsequent satisfaction with their decision.
  
  
  METHODS
  A questionnaire was sent to 819 patients who underwent mastectomy from 1994 to 1998 in a community-based health system.
  
  
  RESULTS
  Response rate was 50% (408 of 819). Overall, 92% (n = 243) of women who did not have reconstruction and 89% (n = 152) of women who did proceed with reconstruction were happy with their decision. Fifty-five (17%) respondents were not offered reconstruction. For this group, age was a significant factor as 64% of them were 60 years or older (P < 0.0001). Dissatisfied patients were disappointed with their cosmetic, sensory, or functional outcome. Their result did not meet their expectations. There were no significant differences noted on the basis of marital status.
  
  
  CONCLUSIONS
  Ninety percent of patients adjust well to mastectomy whether or not they receive reconstruction if they make informed decisions with realistic expectations. Surgeons should offer reconstruction to women of all ages although patients over 60 years old are less likely to proceed with, and complete, reconstruction.
authors.affiliation: Department of Surgery, Legacy Cancer Services, Oregon Health Sciences University, Good Samaritan Hospital, 1130 NW 22nd St. No. 500, Portland, OR 97210, USA.
authors.forename: Carmen
authors.initials: C
authors.lastname: Baker
authors.forename: Nathalie
authors.initials: N
authors.lastname: Johnson
authors.forename: Joanne
authors.initials: J
authors.lastname: Nelson
authors.forename: Louis
authors.initials: L
authors.lastname: Homer
authors.forename: Deb
authors.initials: D
authors.lastname: Walts
authors.forename: Kathleen
authors.initials: K
authors.lastname: Waldorf
authors.forename: Karen
authors.initials: K
authors.lastname: Boardman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D007258:Informed Consent; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010817:Physician-Patient Relations