Mastectomy Patients' Perspectives on Breast Reconstruction at a Tertiary Care Center in Eastern Saudi Arabia

Breast reconstruction surgery (BRS) following mastectomy offers psychological and physical benefits; however, its acceptance remains limited among patients. Cultural perceptions, lack of awareness, and limited communication with healthcare providers may contribute to this gap.

To assess knowledge, misconceptions, attitudes, barriers, and motivators related to BRS among mastectomy patients in Eastern Saudi Arabia, and to explore associations with demographic and clinical factors.

This cross-sectional survey was conducted from February to June 2025 at King Fahd Hospital of the University, Al Khobar, Saudi Arabia, and included all women who underwent mastectomy for breast cancer between 2016 and 2025. Data were elicited using a self-administered questionnaire assessing demographics, breast cancer history, knowledge and misconceptions about BRS, attitudes, and perceived barriers and motivators.

Of 144 eligible patients, 100 completed the questionnaire (response rate: 69.4%). Only 15% of patients had undergone BRS. Most patients had moderate misconceptions (85%), while 22% had excellent knowledge about BRS. Nonetheless, 65% had a positive attitude and 52% expressed willingness to undergo BRS. Key barriers included fear of additional surgery (42.4%) and lack of knowledge (38.8%), while key motivators were restoring body image (93.3%) and improving self-esteem (80%). In the univariate analysis, significant associations were observed between knowledge levels and factors such as age (P = 0.010), education (P < 0.001), income (P = 0.008), and current/past employment in healthcare (P = 0.008). However, in the multivariate logistic regression analysis, no variable was found to be an independent predictor of high knowledge of BRS.

In breast cancer patients who underwent mastectomy in Eastern Saudi Arabia, there is positive attitude and willingness toward breast reconstruction surgery, yet the proportion of patients who underwent the surgery is low. The primary barriers identified are modifiable, and thus enhanced patient education and counseling may improve decision-making about breast reconstruction surgery.