The association between breast surgeons' attitudes toward breast reconstruction and their reconstruction-related information-giving behaviors: a nationwide survey in Japan

Abstract

Background: Breast reconstruction after breast cancer surgery has come to be regarded as an achievable treatment option to improve patients' quality of life. Although it has been pointed out that surgeons' information-giving behaviors affect women's decision to undergo breast reconstruction surgery, little is known about the factors that influence these behaviors. This study investigated Japanese surgeons' reconstruction-related information giving to patients and the factors that affect these behaviors.

Methods: A nationwide postal survey of 1313 board-certified Japanese breast surgeons was conducted. In the questionnaire, surgeons were asked about their reconstruction-related information-giving behaviors and their attitudes toward six hypothetical critical statements regarding breast reconstruction.

Results: Among 635 responding surgeons, 199 (31.3 percent) answered that they did not give reconstruction-related information at all when explaining breast cancer treatment options, and 291 (45.8 percent) stated that they selectively choose patients with whom they provide information based on patients' backgrounds such as age and marital status. Results from the multiple logistic regression analysis indicated that respondents who agreed to the statements "Breast reconstruction may delay the detection of local recurrence," "The aesthetic results of reconstructed breasts are not worth the cost and effort involved," "Breast reconstruction is a luxury," and "Surgeons should pursue breast conserving surgery rather than breast reconstruction" showed significantly decreased likelihood to give reconstruction-related information to patients.

Conclusion: Surgeons need to be aware of the adverse effect that their own attitudes and values with regard to breast reconstruction may have on a patient's ability to choose treatment options.