C. R. Vargas1, M. Paul1, O. Ganor1, M. Semack1, B. T. Lee1 1Beth Israel Deaconess Medical Center,Surgery/Plastic And Reconstructive Surgery,Boston, MA, USA
Introduction:
There is currently considerable variability at our institution in the timing of consultation with a plastic and reconstructive surgeon following initial diagnosis of breast cancer and meeting with a breast surgeon. Providers in both specialties have expressed differing opinions regarding the ideal method of scheduling, and no published data exists regarding what patients prefer. We aim to elucidate patients' preferences for the timing of plastic surgery consultation as part of the preoperative evaluation and planning process that follows a new diagnosis of breast cancer.
Methods:
A 16-question electronic survey instrument was developed based on formative patient comments and discussion between the breast and plastic surgery teams. The survey was administered to all patients referred to the plastic and reconstructive surgery clinic during their initial consultation visit to discuss immediate post-mastectomy breast reconstruction between December 2013 and July 2014. Surveys were administered in private consultation rooms by the clinic nurse and all data was collected anonymously. Descriptive analysis was performed for each survey question.
Results:
A total of 31 unique responses were collected during the 7 month study period. The largest number of patients (48%) indicated that they would prefer to see a plastic surgeon one week after their first consultation with a breast surgeon. Only one patient reported a desire to see both surgeons on the same day. Most patients indicated that having a family member or friend accompany them to the appointment (45%) and having time to process their cancer diagnosis before seeing the plastic surgeon (32%) were the key factors in deciding when they would like to discuss reconstruction. All patients reported having had a discussion with their breast surgeon about reconstruction during the first appointment, and 55% said they had researched reconstructive options independently prior to consultation with the plastic surgeon. All patients reported being "satisfied" or "very satisfied" with the process of meeting with both surgeons as well as with the information they received.
Conclusion:
The majority of patients in our study indicated a preference for delay between initial consultation with a breast surgeon and initial consultation with a plastic surgeon. Overall, patients were satisfied with the process of meeting with each surgeon separately and with the information they received. Incorporating patient preferences into the preoperative evaluation and planning process allows patients to optimize available support from loved ones and to begin coping with their diagnosis.
