Vargas Christina R, Ganor Oren, Semnack Maria, Lin Samuel J, Tobias Adam M, Lee Bernard T
Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
J Surg Res. 2015 May 15;195(2):412-7. doi: 10.1016/j.jss.2015.02.014. Epub 2015 Feb 14.
Patient access to breast reconstruction is an important component of comprehensive breast cancer care. There is currently considerable variability in the timing of consultation with a plastic and reconstructive surgeon after the initial diagnosis of breast cancer. This study aims to elucidate patients' preferences for the timing of plastic surgery consultation as part of the preoperative evaluation and planning process.
A 16-question electronic survey instrument was developed based on formative patient comments and discussion between the breast oncology and plastic surgery teams. The survey was administered to all patients referred to the plastic and reconstructive surgery clinic for initial reconstructive consultation during the study period.
A total of 31 responses were collected. The largest number of patients (48%) indicated they would prefer to see a plastic surgeon 1 wk after their first consultation with a breast surgeon. Only one patient reported a desire to see both surgeons on the same day. Most patients indicated that having a family member or friend accompany them to the appointment (45%) and having time to process their cancer diagnosis before seeing the plastic surgeon (32%) were key factors in deciding when they would like to discuss reconstruction.
Most patients in our study indicated a preference for delay between initial consultation with a breast surgeon and initial consultation with a plastic surgeon. Incorporating patient preferences into the preoperative evaluation and planning process allows patients to optimize available support from loved ones and to begin coping with their diagnosis.
患者接受乳房重建是综合乳腺癌护理的重要组成部分。目前，乳腺癌初步诊断后与整形和重建外科医生会诊的时间存在很大差异。本研究旨在阐明患者对整形手术会诊时间的偏好，作为术前评估和规划过程的一部分。
根据患者的形成性意见以及乳腺肿瘤学和整形手术团队之间的讨论，开发了一份包含16个问题的电子调查问卷。在研究期间，对所有转诊至整形和重建外科诊所进行初次重建会诊的患者进行了调查。
共收集到31份回复。最大比例的患者（48%）表示，他们希望在首次与乳腺外科医生会诊后1周内见到整形医生。只有1名患者表示希望在同一天见到两位医生。大多数患者表示，有家庭成员或朋友陪同就诊（45%）以及在见到整形医生之前有时间处理癌症诊断结果（32%）是决定何时讨论重建问题的关键因素。
我们研究中的大多数患者表示倾向于在初次与乳腺外科医生会诊和初次与整形医生会诊之间有所延迟。将患者偏好纳入术前评估和规划过程，可使患者优化来自亲人的可用支持，并开始应对其诊断结果。
