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Assessment of Knowledge and Attitudes Regarding Breast Reconstruction of Ohio Clinicians Responsible for the Treatment of Breast Cancer Patients
Myla N. Bennett MD, Rohit Jaiswal, Ergun Kocak MD, Charles Rhoads III, Michael J. Miller MD
The Ohio State University Medical Center, Plastic Surgery
2010-03-30
Presenter: Myla Bennett MD
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Although breast reconstruction after mastectomy can offer dramatic improvement in a woman's self esteem and body image, many women never undergo reconstruction. Despite this fact, breast reconstruction following mastectomy is quite low. The United States and Canada both report reconstruction rates as low as 8%.
Methods: A survey was mailed to 2071 Ohio physicians, including family practitioners, medical oncologists, surgical oncologists, and plastic surgeons. The survey consisted of 24 items including physician demographics, perceptions and experiences regarding breast reconstruction, and self-assessment of reconstruction knowledge.
Results: The overall rate at which providers routinely refer breast cancer patients for reconstruction was 43.4%. Practice setting was a highly significant predictor of routine referral, with those respondents practicing in urban settings having higher referral rates than those in non-urban settings (p < 0.0001). Medical specialty was a predictor of routine referral, with medical and surgical oncologists referring at higher rates than family practitioners (p = 0.0459). Providers with higher self-assessment scores referred more than providers with lower scores (p < 0.0001). Medical and surgical oncologists believe that reconstruction interferes with adjuvant therapy compared to family practitioners (p = 0.0002). Family practitioners believe that reconstruction has excessive costs (p = 0.0025).
Conclusion: Our survey indicated, a number of factors correlated with referral rates among practitioners. These included the practice location, knowledge of reconstruction and perceived drawbacks of reconstruction.
