Survey Finds More Women Choosing To ‘Go Flat’ After Mastectomy

Lack of surgeon support was the leading cause of dissatisfaction.

A survey has found most women are satisfied with their decision not to have breast reconstructive surgery (BRS) after a mastectomy. “Going Flat” After Mastectomy: Patient-Reported Outcomes, an online survey published in Annals of Surgical Oncology, found that on average patients yielded satisfaction level of 3.72 on a 5-point scale. The study cited that “most patients undergoing mastectomy alone are satisfied with their surgical outcome.”

The contributing factor for patient dissatisfaction was a lack of support from the surgeon. At least 20 per cent of patients felt their surgeon did not support their decision to forgo reconstruction. Some patients were left with excess skin in anticipation that they would change their mind in future—against a preoperative agreement with the surgeon to perform a flat chest wall closure.

These findings contradict previous studies noting that women who do not have BRS lead a poor quality of life compared to those who do. There is growing online support for those who choose to ‘go flat’, and rates for mastectomy-only procedures are rising in the United States. More women are opting to have a mastectomy even when breast-conserving surgery is a suitable option. The authors continued that the ‘going flat’ movement has increased awareness and acceptance of mastectomy without BRS.

The survey was circulated among the Going Flat communities for seven days in 2019. There were almost 1,110 responses with 931 used in final data analysis. All of the respondents were women with a mean age of 49. The average survey respondent was white and was either married or in a stable relationship. 73.7 per cent said that mastectomy alone was their first choice, with most saying that fast recovery times and avoiding placement of a foreign device as reasons for this.

Other findings showed that 14.9 per cent of respondents underwent breast mould reconstruction that was subsequently removed. In 69 per cent of the cause, this was because of implant problems.

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