Study finds growing number of women adopt ‘going flat’ after mastectomy

A growing number of women for reconstruction after mastectomy say they are satisfied with their choice, even because some did not feel supported by their doctor, according to a study led by gynecologists. research at the UCLA Jonsson Comprehensive Cancer Center.

The study, published in the Journal History of Medical Oncology, studied 931 women who had unilateral or bilateral mastectomy without breast augmentation reconstruction to assess the motivating factors for undergoing the procedure and to determine whether surgeons provides enough information and support to “go flat.”

Of the women surveyed, 74% were satisfied with their outcome and 22% experienced “flat rejection,” where the procedure was not initially offered, the surgeon did not support the procedure. -closure of the patient, or left excess skin despite the patient changing it. mind.

The team also examined reasons given for the choice and found that women expressed a desire to recover more quickly, avoiding foreign body position and the belief that breast reconstruction was not important. for the image of their body.

Performing a mastectomy with or without reconstruction is often a very personal choice. We found that, for a subset of women, ‘going flat’ is a desirable and deliberate option, which should support the treatment team and should not be means that women who forget to rebuild are not related to their postpartum appearance. “

Deanna Attai, Clinical Professor of Surgery, David Geffen School of Medicine at UCLA, and Lead Author of the Study

The results challenge previous studies showing that patients who choose not to undergo breast reconstruction have a worse quality of life compared to those who receive the surgery.

Attai and its team found that a majority of patients who chose to go flat were satisfied with their surgical outcome. The authors believe that the survey tool commonly used to determine results was biased toward reconstruction. To avoid that bias, Attai partnered with patient advocates to develop a specific study to assess reasons for going smoothly, satisfaction with their decision, and satisfaction-related factors. . They also identified concerns that were unique to these patients that had not been captured by other confirmatory studies.

While the majority of women surveyed said they were satisfied with their surgical results, 27% of patients surveyed said they were not satisfied with the appearance of their breast wall.

“Some patients have been told that too much skin has been deliberately left – despite preoperative approval to perform a flat chest wall closure – for use in future reconstructions, for fear ‘ s that the patient would change her mind, “said Attai, who is a member of the UCLA Jonsson Comprehensive Cancer Center. “It surprised us that some women had to struggle to get the procedure they wanted.”

Surgeons may find it difficult to recommend mastectomy without reconstructive surgeons because they are less confident that they can deliver a cosmetically acceptable result to patients who want a flat chest wall, Attai noted. fa-near.

“We hope the results of this study will inform general and breast surgeons that going flat is a legitimate option for patients, and one that must be offered as an option,” Attai said. “We also hope the results will help inform patients that going flat is an option, and empower them to seek surgeons who offer this option. and which respects their decision. “