caa a22 4500 445333383 CHVBK 20180317142744.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1245/s10434-010-1509-y doi (NATIONALLICENCE)springer-10.1245/s10434-010-1509-y Receipt of Delayed Breast Reconstruction After Mastectomy: Do Women Revisit the Decision? [Elektronische Daten] [Amy Alderman, Sarah Hawley, Monica Morrow, Barbara Salem, Ann Hamilton, John Graff, Steven Katz] Background: Postmastectomy breast reconstruction is an important component of breast cancer care, but few receive it at the time of the mastectomy. Virtually nothing is known about receipt of reconstruction after initial cancer therapy and why treatment might be delayed. Materials and Methods: A 5-year follow-up survey was mailed to a population-based cohort of mastectomy-treated breast cancer patients who were initially surveyed at time of diagnosis in 2002 and reported to the Los Angeles and Detroit SEER registries (N=645, response rate 60%). Outcomes were receipt of reconstruction (immediate [IR], delayed [DR], or none) and patient appraisal of their treatment decisions. Results: About one-third (35.9%) had IR, 11.5% had DR, and 52.6% had no reconstruction. One-third delayed reconstruction because they focused more on other cancer interventions, and nearly half were concerned about surgical complications and interference with cancer surveillance. Two-thirds of those with no reconstruction said that the procedure was not important to them. A large proportion of all patients were satisfied with their reconstruction decision-making (89.4% IR, 78.4% DR, 80.4% no reconstruction, P=NS). However, only 59.3% of those with no reconstruction felt that they were adequately informed about their reconstructive options (vs 82.7% IR and 78.4% DR, P<.01). Conclusions: There was modest uptake of breast reconstruction after initial cancer treatment. Factors associated with delayed reconstruction were primarily related to uncertainty about the procedure, concern about cancer surveillance, and low priority. Those without reconstruction demonstrated significant informational needs, which should be addressed with future research efforts. Society of Surgical Oncology, 2010 Alderman Amy Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical Center, Ann Arbor, MI, USA aut Hawley Sarah VA Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, MI, USA aut Morrow Monica Breast Surgery Service, Memorial-Sloan Kettering Cancer Center, New York, NY, USA aut Salem Barbara Division of General Medicine, Department of Internal Medicine, The University of Michigan Medical Center, Ann Arbor, MI, USA aut Hamilton Ann Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA aut Graff John New Jersey State Cancer Registry, Cancer Institute of New Jersey, New Brunswick, NJ, USA aut Katz Steven VA Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, MI, USA aut Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1748-1756 1068-9265 18:6<1748 2011 18 10434 https://doi.org/10.1245/s10434-010-1509-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1509-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Alderman Amy Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical Center, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Hawley Sarah VA Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Morrow Monica Breast Surgery Service, Memorial-Sloan Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Salem Barbara Division of General Medicine, Department of Internal Medicine, The University of Michigan Medical Center, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Hamilton Ann Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Graff John New Jersey State Cancer Registry, Cancer Institute of New Jersey, New Brunswick, NJ, USA aut NATIONALLICENCE 700 1- Katz Steven VA Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, MI, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1748-1756 1068-9265 18:6<1748 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer