Factors Influencing Post-Mastectomy Reconstruction Decisions: Understanding Their Significance

Abstract Introduction: Women undergoing mastectomy have two main choices: either wearing a prosthesis or reconstructive surgery. Despite its importance in physical and psychological recovery, patients and caregivers are still unaware of the various reconstruction options. This study explores factors influencing breast reconstruction decisions after mastectomy. Materials And Methods: In this cross-sectional study, 350 patients were recruited through purposive sampling from an outpatient breast clinic who underwent mastectomy at least a year ago in Liaquat National Hospital and Medical College, Karachi, Pakistan. A questionnaire designed (both in English and Urdu) was distributed among the participants between Jan– April 2022. Written and verbal consent was obtained from all the participants. Results: Responses were analyzed from 350 patients who underwent mastectomy for breast malignancy at least a year before. Over half the participants were above 55 years and most were housewives. While 55.7% used prostheses, 41.4% didn't despite knowing about them, and 2.9% were unaware they existed. Only 48.2% of patients knew about reconstruction, and of those, 23% had no desire for it. Financial constraints (7.1%) and family issues (0.6%) were rarely cited as reasons for not wanting reconstruction. Surgeons (47.7%) and social media (43.1%) were the primary sources of information. The inclination towards breast reconstruction surgery was to gain confidence (305 [87%] women), enhance romantic relationships fulfill their spouses' desires (14 [4%]), and gain positive responses from others (31 [8.9%]). Reluctance to go for another surgery emerged as the primary reason for declining breast reconstruction. Conclusion: There is a combination of sociocultural, economic, and healthcare-related factors influencing Pakistani women's decisions about reconstruction following a mastectomy including a lack of awareness about reconstruction. We recommend that all patients should be counseled about the reconstructive options when their mastectomy is planned.