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Modeling the Arc of Financial Well-Being in Breast Reconstruction: A Mixed-Methods Study
Danielle H Rochlin1, Jenny Chen1, Ayana Cole-Price1
1. Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Plastic and Reconstructive Surgery
|April 9, 2026
Summary
Financial toxicity (FT) in mastectomy patients is influenced by age, race, marital status, and socioeconomic factors, but not reconstruction choices. Improved financial navigation and transparency are needed.
Area of Science:
- Oncology
- Health Economics
- Patient-Reported Outcomes
Background:
- Financial considerations significantly impact healthcare decisions.
- Understanding the interplay between financial toxicity and reconstructive surgery is crucial for patient care.
Purpose of the Study:
- To investigate if financial factors influence reconstructive surgery decisions.
- To determine if reconstructive choices impact patients' financial burden.
Main Methods:
- A mixed-methods study using the Comprehensive Score for Financial Toxicity (COST) questionnaire and semi-structured interviews.
- 1,029 patients undergoing mastectomy completed the COST questionnaire pre- and post-surgery.
- Regression models identified predictors of financial toxicity (FT), and interviews explored patient experiences.
Main Results:
- 30.6% of patients experienced financial toxicity (COST ≤20).
- Predictors of FT included younger age, non-White race, divorced/single marital status, and socioeconomic deprivation.
- Reconstruction receipt, type, or timing did not significantly correlate with baseline FT or changes in financial toxicity.
Conclusions:
- No significant bidirectional relationship was found between financial toxicity and reconstructive surgery decisions.
- Enhanced patient-centric financial navigation and price transparency are recommended to alleviate financial burden.
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