title: An evaluation of factors affecting preference for immediate, delayed or no breast reconstruction in women with high-risk breast cancer.
abstract: Women with locally advanced breast cancer face many conflicting issues affecting their choice of immediate versus delayed versus no breast reconstruction (BR). This single-centre pilot study assessed high-risk women's reasons and priorities in choosing the timing and type of BR in a setting where all clinically feasible options were discussed with all women.
  
  
  
  Fifty-one women from a metropolitan breast oncology practice, who were likely to require post-mastectomy radiotherapy (PMRT), were recruited after making their decision about BR. Participants completed a questionnaire (69% preoperatively), adapted from Reaby (1998), evaluating the factors affecting their decision. Responses were subsequently classified into eight issue-based domains (feeling normal, feeling good, being practical, influence of others, expectations, fear, timing and unnecessary). Demographic and clinical data were also collected.
  
  
  
  There were 32 immediate BR (IBR = 63%), seven delayed BR (DBR = 13%) and 12 no BR (NBR = 23%). Analysis using the chi square test showed women over 60 were more likely to choose NBR (p = 0.005), while women living with a partner were more likely to choose IBR (p = 0.032). The most relevant domains for both IBR and DBR were 'feeling good' and 'feeling normal'; and for NBR were 'unnecessary' and 'being practical'. Although all women understood pre-operatively the potential aesthetic limitations of PMRT, 63% still chose IBR.
  
  
  
  These data will enable clinicians, researchers and women with breast cancer to gain a clearer understanding of the factors that impact on the choice and timing of BR in women requiring PMRT, a major breast cancer survivorship decision. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia.|Northern Clinical School, University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Flitcroft
authors.affiliation: Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia.|Northern Clinical School, University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Meagan
authors.initials: M
authors.lastname: Brennan
authors.affiliation: Psycho-Oncology Co-operative Group, University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Costa
authors.affiliation: Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia.
authors.forename: April
authors.initials: A
authors.lastname: Wong
authors.affiliation: Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia.|Northern Clinical School, University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Kylie
authors.initials: K
authors.lastname: Snook
authors.affiliation: Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia.|Northern Clinical School, University of Sydney, Sydney, NSW, 2006, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Spillane
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery*; D000073116:Cancer Survivors / Q000523:psychology; D002755:Choice Behavior; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology; D018714:Radiotherapy, Adjuvant; D011795:Surveys and Questionnaires; D013997:Time Factors