Preferences for care among African American women considering postmastectomy breast reconstruction Journal Article
| Authors: | Shammas, R. L.; Hung, A.; Ramkalawan, J.; Mullikin, A.; Moore, A.; Greenup, R. A.; Hollenbeck, S. T.; Phillips, B. T.; Matros, E.; Reed, S. D.; Lee, C. N. |
| Article Title: | Preferences for care among African American women considering postmastectomy breast reconstruction |
| Abstract: | Background: Approximately 20% of patients report inadequate discussions with their providers about reconstructive options, with an increased frequency reported in non-White women. Eliciting treatment preferences with adaptive choice-based conjoint (ACBC) analysis can improve our understanding of what patients’ value. We aimed to determine what African American (AA) patients value when considering breast reconstruction options. Methods: Cross-sectional ACBC with AA women considering breast reconstruction recruited through community partnerships and an academic medical center. Relative importance scores, part-worth utilities, and maximum-acceptable risks were calculated to assess preferences for attributes of flap versus implant reconstruction. Results: Overall, 181 women, 101 from an academic center and 80 from the community were included. The most important attributes were risk of complications [mean (SD) relative importance (RI), 26% (12%)], additional surgeries [RI, 24% (14%)], and abdominal morbidity [RI, 22% (11%)]. Women were least concerned with appearance [RI, 15% (12%)] and recovery time [RI, 14%, (10%)]. Fewer women preferred a profile representing flap (n=27, 15%) compared to implant reconstruction (n=154, 85%). Those who preferred flap reconstruction cared most about additional surgeries [RI, 36% (15%)]; in contrast, those who preferred implant reconstruction cared most about complications [RI, 27% (12%)]. Participants with fewer comorbidities [OR, 0.84; p=0.012], no prior surgical complication (OR, 0.32; p=0.029), and prophylactic mastectomy (OR, 6.07; p=0.19) were more likely to choose the implant profile. Conclusion: AA patients place greatest value on minimizing complication risk and additional surgeries when considering post-mastectomy reconstruction. Future studies should assess how eliciting individual-level preferences can improve shared decision-making in surgery. © 2025 Lippincott Williams and Wilkins. All rights reserved. |
| Keywords: | breast cancer; breast reconstruction; patient preferences; patient experiences; conjoint analysis |
| Journal Title: | Plastic and Reconstructive Surgery |
| Volume: | 156 |
| Issue: | 3 |
| ISSN: | 0032-1052 |
| Publisher: | Lippincott Williams & Wilkins |
| Publication status: | Published |
| Date Published: | 2025-09-01 |
| Online Publication Date: | 2025-02-04 |
| Start Page: | 357 |
| End Page: | 366 |
| Language: | English |
| DOI: | 10.1097/prs.0000000000012003 |
| PROVIDER: | scopus |
| PUBMED: | 39903878 |
| DOI/URL: | |
| Notes: | Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work