title: The Internet: What are our patients exposed to when considering breast reconstruction following mastectomy?
abstract: BACKGROUND
  The exponential increase in internet use has transformed the healthcare provider-patient relationship. There is a need to guide patients. This study analyses the information available, clinicians approach and patients' experiences.
  
  
  METHODS
  An internet search, "breast reconstruction after mastectomy" was performed on Google and Bing search engines. The first 100 sites on each search were analysed. Target audience, provider and readability were assessed. Modified Health on the Net criterion was used to assess quality. Additionally clinicians and patients were surveyed about their experiences.
  
  
  RESULTS
  Private companies dominated, accounting for 67% of sites, the majority advertised private healthcare groups. Of "information pages", 16% were government sites and 9% were from professional bodies but 28% were private. Blogs had high rates of surreptitious advertising. Patients wanted guidance on which sites to use. Endorsed sites were commonly recommended and used despite only accounting for 13 of the 100 sites.
  
  
  CONCLUSIONS
  The internet is a powerful tool for disseminating information. There is a wide variety of information presented on breast reconstruction following mastectomy from a range of providers with different interests. Patients should not only be provided with a list of internet resources but also counselled on the types of information they may encounter.
authors.affiliation: South Tyneside District General Hospital, Harton Lane, South Shields NE34 0PL, UK. Electronic address: mrsamylight@gmail.com.
authors.forename: Amy
authors.initials: A
authors.lastname: Light
authors.affiliation: South Tyneside District General Hospital, Harton Lane, South Shields NE34 0PL, UK. Electronic address: C.j.munro.05@aberdeen.ac.uk.
authors.forename: Colin
authors.initials: C
authors.lastname: Munro
authors.affiliation: Plastic Surgery Department, Royal Victoria Infirmary, Queen Victoria Road, Newcastle NE1 4LP, UK. Electronic address: willianbreakey@gmail.com.
authors.forename: William
authors.initials: W
authors.lastname: Breakey
authors.affiliation: Breast Surgery Department, Royal Victoria Infirmary, Queen Victoria Road, Newcastle NE1 4LP, UK. Electronic address: Adam.Critchley@doctors.org.uk.
authors.forename: Adam
authors.initials: A
authors.lastname: Critchley
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D054626:Consumer Health Information; D003657:Decision Making; D005260:Female; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D016462:Mammaplasty; D008408:Mastectomy
keywords: Breast reconstruction; Decision making; Information provision; Internet