Patient challenges across the implant-based breast reconstruction journey: A qualitative descriptive study

To explore patient-perceived challenges across different phases of the implant-based breast reconstruction journey following breast cancer surgery, and to inform stage-specific supportive nursing care.

A qualitative descriptive design was used. Eighteen women who had undergone implant-based breast reconstruction at a cancer hospital in Shanghai, China, were recruited through purposive sampling to achieve variation in age, education, and treatment experience. Semi-structured interviews were conducted between January and March 2025. Timing Theory informed the temporal structure of the interview guide and the temporal organization and interpretation of findings. Data were analyzed using thematic analysis, with codes and themes developed inductively from participants' narratives without using Timing Theory as a coding framework. Trustworthiness was enhanced through independent coding, team discussions, participant feedback, and detailed documentation of the analytic process.

Four data-derived themes were identified. These themes reflected challenges across different phases of the reconstruction journey: (1) Uncertainty regarding adverse outcomes of implant-based reconstruction; (2) Conflicting demands of functional recovery and implant shaping; (3) Conflicting care guidance during radiotherapy; and (4) Psychological burden of living with a permanent implant.

Women undergoing implant-based breast reconstruction experience distinct challenges that evolve throughout the reconstruction journey. Based on these findings, nursing strategies addressing these challenges, including clearer decision-related information, rehabilitation guidance, consistent treatment-related communication, and psychosocial support, may help patients navigate reconstruction-related difficulties. Addressing these challenges may improve adaptation, strengthen self-management, and enhance the overall reconstruction experience.