Breast reconstructive surgery: level of acceptance, asociated patient and disease facilitating factors and barriers among women with breast cancer post mastectomy in Mulago hospital.

Abstract

INTRODUCTION: Breast reconstructive surgery is an important aspect of management of breast cancer especially in improving quality of life of patients after mastectomy. Previous studies show that a range of factors including socio-demographic, socioeconomic, disease characteristics and the health systems of the area affect the acceptance of breast reconstructive surgery. OBJECTIVE: The aim of the study was to determine factors influencing the acceptance of breast reconstructive surgery after mastectomy among patients with breast Cancer in Mulago Hospital. METHODS: It was a cross sectional study on 389 women of 18years and above post mastectomy. The patient and disease factors influencing acceptance of breast reconstructive surgery were assessed using a semi-structured questionnaire. The level of acceptance of BRS was analyzed using proportions and factors associated with acceptance of breast reconstructive surgery by bivariate analysis. Factors with p-value less than 0.2 at the bivariate level were entered into the multivariable logistic regression model to adjust for potential confounders. Factors with p-value less than 0.05 at multivariate stage were considered significant. The results were presented in tables and texts as appropriate. Thematic content analysis were used to analyze the qualitative data from the Focus group discussions. RESULTS: The study recruited 389 participants and level of acceptance of BRS was 22.6%. The main factors associated with acceptance were age less than 47years, having had mastectomy more than a year prior, having a partner and stigma. Those who were not willing to accept BRS cited reasons such as fear of additional surgery, worry about complications and lack of knowledge.

CONCLUSION: The level of acceptance among post mastectomy women is low in Mulago due to lack of knowledge about the procedure and fear of additional surgery. Age less than 47 and having a partner were major factors in increasing acceptance of breast reconstruction.