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The nature and importance of women's goals for immediate and delayed breast reconstruction

Guest, Ella; Paraskeva, Nicole; Griffiths, Catrin; Hansen, Esther; Clarke, Alex; Baker, Elisabeth; Harcourt, Diana

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Ella Guest
Occasional Associate Lecturer - CHSS - HSS

Catrin Griffiths
Occasional Associate Lecturer - HAS HSS

Esther Hansen

Alex Clarke

Elisabeth Baker

Diana Harcourt
Professor in Appearance Research


Objectives: Increasingly, women undergo breast reconstruction (BR) surgery to restore health-related and psychosocial quality of life after mastectomy. Most research focuses on BR outcomes rather than women's pre-surgical expectations of, and goals for, immediate (IBR) or delayed (DBR) procedures, yet such information could support women's decision-making. This study aimed to investigate women's BR goals, whether they differed according surgery timing (IBR or DBR), and the importance women placed on them. Methods: Seventy-six women considering DBR (n = 50) or IBR (n = 26) at a UK hospital were encouraged to clarify their BR goals and rate the importance of achieving each one. Content analysis categorised and counted the frequency of the goals they reported. Results: Fifteen goal categories (7 surgical, e.g. scarring; 8 psychosocial/lifestyle, e.g. feeling feminine) were identified. Many (e.g. scarring, intimacy) were reported by a similar percentage of women in each surgical group, however, differences were identified (e.g. breast sensation was not mentioned by women considering IBR). Women reported more psychosocial (n = 206) than surgical goals (n = 160). Further, an independent t-tests revealed that women in both groups placed significantly more importance on the psychosocial (M = 9.4) than surgical goals (M = 8.5). Conclusions: This study highlights the variety of goals women have for BR, the importance they attach to them, and differences and similarities between those seeking IBR and DBR. Future research should consider whether BR goals are met, how goal achievement influences satisfaction with outcome over time and how best to incorporate goals into pre-surgical treatment decision-making.


Guest, E., Paraskeva, N., Griffiths, C., Hansen, E., Clarke, A., Baker, E., & Harcourt, D. (2021). The nature and importance of women's goals for immediate and delayed breast reconstruction. Journal of Plastic, Reconstructive and Aesthetic Surgery, 74(9), 2169-2175.

Journal Article Type Article
Acceptance Date Dec 20, 2020
Online Publication Date Jan 9, 2021
Publication Date Sep 1, 2021
Deposit Date Feb 1, 2021
Publicly Available Date Jan 10, 2022
Journal Journal of Plastic, Reconstructive and Aesthetic Surgery
Print ISSN 1748-6815
Electronic ISSN 1878-0539
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 74
Issue 9
Pages 2169-2175
Keywords Surgery, Breast cancer, Breast reconstruction, Surgical decision-making, Expectations, Goals
Public URL


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