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Published on: May 17, 2024
Patients' preferences for breast reconstruction: a discrete choice experiment
Tim H C Damen1, Esther W de Bekker-Grob, Marc A M Mureau
1Department of Plastic and Reconstructive Surgery, Erasmus University Medical Centre, P.O. Box 2040, Nl-3000 CA Rotterdam, The Netherlands. t.damen@erasmusmc.nl
Patients undergoing breast reconstruction (BR) prefer autologous free flap procedures, prioritizing excellent aesthetic results and acceptable complication rates. Understanding these preferences improves patient counseling for reconstructive surgery decisions.
Area of Science:
- Plastic Surgery
- Patient-Reported Outcomes
- Decision Analysis
Background:
- Patient preferences significantly influence the choice of breast reconstruction (BR) modality.
- Understanding patient considerations can enhance counseling for BR decisions.
- This study utilized a discrete choice experiment (DCE) to explore preferences for BR.
Purpose of the Study:
- To explore patient preferences for three breast reconstruction (BR) modalities.
- To determine the relative importance of various BR attributes and patient trade-offs.
Main Methods:
- A discrete choice experiment (DCE) was conducted with 247 patients who had undergone mastectomy and BR.
- Patients evaluated hypothetical BR profiles based on material, operations, complication rates, aesthetics, and waiting time.
- Multinomial logit regression analyzed attribute importance and trade-offs.
Main Results:
- All treatment characteristics were important in patient choices.
- Autologous material and excellent aesthetic results had the greatest positive impact on preferences.
- Autologous free flap BR aligned best with patient preferences, with complication rates of 20-30% negatively impacting choices.
Conclusions:
- Patient preferences for breast reconstruction (BR) involve weighing various attributes and trade-offs.
- Autologous free flap reconstruction is favored when considering aesthetics and complications.
- Clinical judgment remains essential for tailoring BR techniques to individual patient needs and feasibility.