A Franco-British patients' and partners' satisfaction audit of breast reconstruction

SummaryAimsTo compare French and British patients' and partners' satisfaction with breast reconstruction after mastectomy and determine what factors affect it.MethodologyThe study analysed validated questionnaires from 182 pairs (the woman and her partner), split equally between France and the UK. The patients underwent breast surgery at the Norfolk and Norwich University Hospital (NNUH) and at the Hôpital Saint-Louis in Paris, France. All main surgical procedures were considered.ResultsParticipants were satisfied with the outcome but satisfaction levels differed between France and the UK, British patients reporting higher satisfaction (P = 0.029) because of a closer match between their expectation and the outcome.There were also statistically significant differences in:1.The decision-making process and the factors influencing it: Consultants and partners were more influential in France.2.Satisfaction with information: French participants felt less well informed.3.Pain control management: higher satisfaction was reported in France.4.The confidence level shown after breast reconstruction: British patients felt more confident.5.The importance of the determinants of aesthetic satisfaction: higher expectation levels were reported by the French for all determinants.6.Satisfaction with determinants: symmetry and shape scored lowest in both countries; French patients expressed highest satisfaction for implants and British patients for latissimus dorsi (LD) and deep inferior epigastric perforator (DIEP) flaps.There was no difference in satisfaction levels between patients and partners who accurately reported on patients' views and whose own views matched patients'. Satisfaction was correlated to the level of information, pain management, recovery time, technique used, cosmetic results, intervention timing, but not to the independent assessment of the outcome.