Jennifer L Baker1, Don S Dizon2, Cachet M Wenziger3, Elani Streja3, Carlie K Thompson1, Minna K Lee1, Maggie L DiNome1, Deanna J Attai4,5. 1. Department of Surgery, University of California Los Angeles, Los Angeles, CA, USA. 2. Brown University and the Lifespan Cancer Institute, Providence, RI, USA. 3. Department of Medicine, University of California Irvine School of Medicine, Irvine, CA, USA. 4. Department of Surgery, University of California Los Angeles, Los Angeles, CA, USA. dattai@mednet.ucla.edu. 5. UCLA Health Burbank Breast Care, Burbank, CA, USA. dattai@mednet.ucla.edu.
Abstract
BACKGROUND: The Going Flat movement aims to increase awareness and acceptance of mastectomy alone as a viable option for patients. Little is known about motivations and satisfaction with surgical outcomes in this population. METHODS: An online survey was administered to 931 women who had a history of uni- or bilateral mastectomy for treatment of breast cancer or elevated breast cancer risk without current breast mound reconstruction. Satisfaction with outcome and surgeon support for the patient experience were characterized using 5-level scaled scores. RESULTS: Mastectomy alone was the first choice for 73.7% of the respondents. The top two reasons for going flat were desire for a faster recovery and avoidance of a foreign body placement. Overall, the mean scaled satisfaction score was 3.72 ± 1.17 out of 5. In the multivariable analysis, low level of surgeon support for the decision to go flat was the strongest predictor of a satisfaction score lower than 3 (odds ratio [OR], 3.85; 95% confidence interval [CI], 2.59-5.72; p < 0.001). Dissatisfaction also was more likely among respondents reporting a body mass index (BMI) of 30 kg/m2 or higher (OR, 2.74; 95% CI, 1.76-4.27; p < 0.001) and those undergoing a unilateral procedure (OR, 1.99; 95% CI, 1.29-3.09; p = 0.002). Greater satisfaction was associated with receiving adequate information about surgical options (OR, 0.48; 95% CI, 0.32-0.69; p < 0.0001) and having a surgeon with a specialized breast surgery practice (OR, 0.56; 95% CI, 0.38-0.81; p = 0.002). CONCLUSIONS: Most patients undergoing mastectomy alone are satisfied with their surgical outcome. Surgeons may optimize patient experience by recognizing and supporting a patient's decision to go flat.
BACKGROUND: The Going Flat movement aims to increase awareness and acceptance of mastectomy alone as a viable option for patients. Little is known about motivations and satisfaction with surgical outcomes in this population. METHODS: An online survey was administered to 931 women who had a history of uni- or bilateral mastectomy for treatment of breast cancer or elevated breast cancer risk without current breast mound reconstruction. Satisfaction with outcome and surgeon support for the patient experience were characterized using 5-level scaled scores. RESULTS: Mastectomy alone was the first choice for 73.7% of the respondents. The top two reasons for going flat were desire for a faster recovery and avoidance of a foreign body placement. Overall, the mean scaled satisfaction score was 3.72 ± 1.17 out of 5. In the multivariable analysis, low level of surgeon support for the decision to go flat was the strongest predictor of a satisfaction score lower than 3 (odds ratio [OR], 3.85; 95% confidence interval [CI], 2.59-5.72; p < 0.001). Dissatisfaction also was more likely among respondents reporting a body mass index (BMI) of 30 kg/m2 or higher (OR, 2.74; 95% CI, 1.76-4.27; p < 0.001) and those undergoing a unilateral procedure (OR, 1.99; 95% CI, 1.29-3.09; p = 0.002). Greater satisfaction was associated with receiving adequate information about surgical options (OR, 0.48; 95% CI, 0.32-0.69; p < 0.0001) and having a surgeon with a specialized breast surgery practice (OR, 0.56; 95% CI, 0.38-0.81; p = 0.002). CONCLUSIONS: Most patients undergoing mastectomy alone are satisfied with their surgical outcome. Surgeons may optimize patient experience by recognizing and supporting a patient's decision to go flat.
Authors: Michelle E Wakeley; Colette F Bare; Rebecca Pine; Catherine Dube; Jennifer S Gass; Charu Taneja; Don S Dizon Journal: Breast J Date: 2020-02-18 Impact factor: 2.431
Authors: Deanna J Attai; Matthew S Katz; Elani Streja; Jui-Ting Hsiung; Maria V Marroquin; Beverly A Zavaleta; Larissa Nekhlyudov Journal: J Cancer Surviv Date: 2022-02-03 Impact factor: 4.442
Authors: Daniel Steffens; Elisabeth A Kappos; Alexander Lunger; Fabienne D Schwab; Lea Zehnpfennig; Walter Paul Weber; Martin Haug; Viola Heinzelmann-Schwarz; Christian Kurzeder Journal: World J Surg Oncol Date: 2022-02-21 Impact factor: 2.754