Abstract
Introduction
Post-mastectomy radiotherapy (PMRT) is recommended to women at high risk of local recurrence. There is a paucity of published work on the experience of women who undergo deep inferior epigastric perforator (DIEP) flap breast reconstruction in the context of requiring PMRT. The aim of the study was to explore and understand the patient experience of these women.
Methods
Purposive sampling was used to identify patients who had undergone an immediate reconstruction with PMRT and women who had undergone a delayed reconstruction after PMRT. Purposive sampling was used to identify and invite women to participate in the study. Semi-structured interviews were conducted using a grounded theory approach with a topic guide which was derived from relevant literature.
Results
Twenty women participated in the study. Ten women had undergone immediate reconstruction followed by PMRT and 10 women had undergone delayed reconstruction after PMRT. The results suggest that, regardless of the surgical pathway or the consequences of treatment, overall women were satisfied with the treatment decision they had made. Patients described the challenges around decision-making and their post-operative experience. However, patients were grateful to have had a breast reconstruction and in the most part happy with the treatment pathway they underwent.
Conclusion
The findings of this study suggest that women are motivated by a variety of factors when presented with the choice of immediate versus delayed breast reconstruction and can justify the treatment path they have taken. This study highlights the importance of discussing reconstruction options in terms of context of a person’s life and coping strategies. Patients appeared to use self-regulation in their behaviour to cope with their illness threat and decision-making. The women who chose delayed reconstruction were motivated by the delayed gratification of having a reconstruction that had not been subjected to PMRT.