Preferences for Breast Reconstruction in African American Women Highlight Concerns About Complications and Appearance

A recent study emphasizes that African American women undergoing mastectomy prioritize the risk of complications and the aesthetic outcome when considering breast reconstruction options. The research, published in Plastic and Reconstructive Surgery, involved 181 women with breast cancer or high genetic risk, exploring their treatment preferences through an innovative method called adaptive choice-based conjoint (ACBC) analysis.

This method provided participants with detailed information about implant-based and autologous (tissue-based) reconstruction, including visual aids showing potential results and scarring, to help them weigh their options effectively. The findings revealed that the most significant factor influencing decision-making was the potential for major complications, accounting for 26% of the importance weighting. Appearance outcomes followed at 15%, with other considerations like additional surgeries, impact on abdominal appearance, and recovery time also playing roles.

The study found that 85% of women favored implant reconstruction, especially among healthier individuals and those opting for preventive mastectomy. Conversely, 15% preferred autologous reconstruction, mainly because they valued the appearance of the reconstructed breast higher and were willing to accept increased risks of complications and abdominal impact.

Importantly, the research highlights the necessity of active patient engagement via tools like ACBC, which facilitate understanding personal values and preferences. Such approaches are critical for ensuring shared decision-making, particularly among marginalized groups like African American women, who historically report lower participation in treatment decisions. The study notes that two-thirds of participants found the ACBC exercise highly helpful, reinforcing its potential to improve communication between patients and healthcare providers.

The authors emphasize that incorporating patient-centered tools can enhance treatment discussions by aligning medical options with individual values, leading to more satisfactory outcomes. They advocate for increased use of preference elicitation strategies to support health equity and empower women to make informed choices about their breast reconstruction options.

For further insights, the original study can be referenced at: source.