Women's Satisfaction with Surgery
Yesterday I wrote about the impact of individual surgeons' personal characteristics on their recommendations for breast surgery. As I said then, there has been much more written about patients' perceptions, and most of us would agree that is even more important. A recent article by Anne Klassen, MD and her colleagues looks at satisfaction among three groups of women: those who had reconstruction following breast cancer surgery, those who had breast augmentation, and those who had breast reduction. Note that the second two groups were not dealing with breast cancer.
Dr. Klassen suggests that patient satisfaction must be considered in the following areas:
Satisfaction with breasts
Satisfaction with the overall outcome
Psychosocial well being
Sexual well being
Physical well being
Satisfaction with the process of care
I certainly agree with her thoughts, but have a fair amount of difficulty with a study that considers both women with and without breast cancer. My own belief that that their perspectives and experiences are so vastly different that it is difficult, if not impossible, to draw shared conclusions. Although I have not worked with many women who have had cosmetic breast surgery, I have known a few. These were women who had earlier breast surgery and later were diagnosed with breast cancer. When they spoke of the two experiences and surgical choices, they were clear that their worlds were turned upside down the second time. They made many distinctions between their process of decisions and care—let alone between their concerns and satisfaction. One very small example would be that reconstructions after mastectomy are much less likely to have the same fabulous cosmetic outcome as breast augmentation surgery. There are big surgical differences in technique and safe choices (as in, skin-sparing mastectomies are often not offered to breast cancer patients). The larger reasons, of course, have to do with all the other feelings and issues which accompany a cancer diagnosis.
If you want to read more, here is the link: http://www.biomedcentral.com/1472-6874/9/11
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