Breast reconstruction after mastectomy: a survey of general surgeons in Singapore.

BACKGROUND: Breast cancer is the leading malignancy among women in Singapore. In the West as many as 30% of eligible patients undergo some form of reconstruction, but in Singapore breast reconstruction is not often performed.

METHODS: A postal survey of general surgeons in Singapore (response rate of 46%) was conducted to ascertain the factors influencing their decision to refer for reconstruction and the possible concerns they had about reconstruction.

RESULTS: Age, anticipated psychosocial morbidity and the need for adjuvant therapy were the most important factors identified. The survey also found that almost 30% of respondents were unsure of whether reconstruction would mask recurrence. Despite this, almost 80% of respondents felt that reconstruction was worth the effort, but 55% (compared to less than 20% in the West) felt that patients did not want reconstruction despite being advised of its availability.

CONCLUSION: Lack of information and the perception that patients would not want reconstruction may be important reasons for the low emphasis placed on the role of breast reconstruction in post-mastectomy patients.