Decision-making Tools for Postmastectomy Breast Reconstruction: A Scoping Review

Breast reconstruction is an essential consideration for patients with breast cancer undergoing a mastectomy. Patients commonly report inadequate education as an important cause of dissatisfaction with breast reconstructive care. Information sources for breast reconstruction vary in quality, accuracy, and validity. We sought to determine what academic and nonacademic resources exist supporting decision-making for patients undergoing breast reconstruction.

A search was conducted of both academic literature and nonacademic social media sources. Three academic databases and 5 social media platforms were searched using keywords. Three independent reviewers performed the selection and data extraction of sources that met the inclusion criteria.

A total of 1172 academic articles and 1419 nonacademic records were screened, with 14 and 9 included for final review, respectively. Of the 5 nonacademic mediums searched, none were included from TikTok and Instagram. One decision-making tool (DMT) was included from Twitter, 4 from YouTube, and 4 from Google. Overall, the quality of available DMTs was very good. The one included academic DMT had a mean DISCERN score of 5, whereas the 4 DMTs from Google and Twitter had a median DISCERN score of 4. YouTube videos were ranked using the modified DISCERN tool with a median score of 5.

Accessibility was found to be a significant barrier for patients in academic and nonacademic platforms with significant knowledge required to effectively search these platforms for resources. Efforts must be made to improve accessibility and awareness of these DMTs, as such tools are essential in shared decision-making.