Reconstruction decisions | ASK THE EXPERT

Women who need to undergo a mastectomy face the difficult decision of whether to restore breast shape after surgery. The Beacon spoke to Associate Professor Kerry Sherman, Macquarie University, about BRECONDA, an interactive tool developed by Kerry and a team of researchers to help women make decisions about breast reconstruction.

What is BRECONDA?

BRECONDA is a free, interactive decision-making tool that is now available on BCNA’s website. BRECONDA guides women through a series of questions to help decide if a breast reconstruction is right for them. At Macquarie University, we developed the tool with an international team of researchers, clinicians and surgeons. The tool has been created to assist women diagnosed with early breast cancer and also women diagnosed with DCIS (ductal carcinoma in situ).

The decision about whether, and how, to undergo breast reconstruction surgery is difficult and women are often under pressure to make a decision quickly. Studies show that 20-30 per cent of Australian women feel regret following their decision about breast reconstruction. This is often because women are stressed at the time of making a decision and do not have enough information on the sorts of things they need to think about before deciding.

We wanted to develop an online tool that could help women to make informed choices about breast reconstruction, to feel more confident when having discussions with their surgeon and to feel happier about their decisions.

BRECONDA gives detailed information online about the range of breast reconstruction surgical types available, what they feel and look like, and options for immediate or delayed breast reconstruction.

This helps to build realistic expectations and a balanced view about breast reconstruction. BRECONDA is designed to lead you through the decision-making process at your own pace. The questions can be answered from the comfort of home and in your own time.

How can BRECONDA help me?

The tool will help you learn about the breast reconstruction options available and the advantages and disadvantages of each option. A benefit of BRECONDA is that it offers interactive exercises that help you to clarify your personal values. For example, it can help you identify whether it is important for you to have natural-looking breasts, or whether it is more important to limit the amount of surgery you have. By helping you to identify your values and priorities, decisions about whether to have a reconstruction are guided by what is most important for you and your life.

BRECONDA includes stories from women who have been through this decision-making process. This can help you to weigh up the pros and cons of different options and also show you that you are not alone. Recognising that it can be challenging to make decisions when feeling stressed, BRECONDA also provides simple stress management strategies that can be very helpful.

Another benefit of BRECONDA is that it can help you to talk about your decision with the people you are close to. While BRECONDA is not intended to replace the advice of your breast surgeon, it can help you to have more informed and confident discussions with your treating team. This can also be of benefit for surgeons and specialists, by helping them to feel more informed about your individual needs.

What if I don’t want a breast reconstruction?

BRECONDA is designed to provide you with a balanced picture of the advantages and disadvantages of breast reconstruction and to make choices based on your own personal needs. Whether you choose to have a breast reconstruction or not, BRECONDA can help you in this journey.

We have found through our research that women who use BRECONDA as a guide feel clearer and more certain when they make decisions about breast reconstruction. This helps women to feel more satisfied with outcomes, whatever path they decide to take.

How can I access BRECONDA?

BRECONDA is available free of charge right across the country. You will need access to the internet and will be asked to create a log-in so your responses can be saved and you can come back to the tool later. Visit BCNA’s website bcna.org.au/resource/breconda.

BRECONDA will be reviewed regularly by leading surgeons through Breast Surgeons of Australia and New Zealand to ensure it remains up-to-date with the latest research and knowledge. To help us keep BRECONDA a valuable and relevant tool, women who use the tool are encouraged to leave their feedback.

Associate Professor Kerry Sherman

Associate Professor Kerry Sherman

Issue 78
Autumn 2017