Preconsultation Educational Group Intervention Can Address the Knowledge Gap in Postmastectomy Breast Reconstruction

Area of Science:

• Oncology
• Plastic Surgery
• Patient Decision Making

Background:

• Postmastectomy breast reconstruction (PMBR) is a complex decision influenced by patient preferences and knowledge.
• Optimizing decision quality requires ensuring patients are well-informed and their choices align with personal values.

Purpose of the Study:

• To assess the impact of a preconsultation educational group intervention (PEGI) on patient knowledge, anxiety, and decisional conflict related to PMBR.
• To compare the effectiveness of PEGI against routine education in improving decision quality for women undergoing PMBR.

Main Methods:

• A phase 3 randomized controlled trial involving 156 women undergoing delayed PMBR or prophylactic mastectomy with immediate PMBR.
• The intervention group received a PEGI including surgeon presentations, value clarification, and patient testimonials prior to consultation.
• Outcome measures included the Decisional Conflict Scale, State-Trait Anxiety Inventory, and BREAST-Q, assessed before and after consultation.

Main Results:

• Patient knowledge regarding PMBR significantly improved more in the PEGI group (24.5% increase) than in the routine education group (13.5% increase).
• While decisional conflict reduction was greater in the PEGI group, the difference approached but did not reach statistical significance (P = 0.09).
• No significant baseline differences were observed between groups in demographics, clinical status, knowledge, anxiety, or decisional conflict.

Conclusions:

• A preconsultation educational group intervention effectively enhances patient knowledge about postmastectomy breast reconstruction.
• PEGI offers a valuable strategy to bridge the knowledge gap for patients considering delayed or immediate breast reconstruction after mastectomy.