Supporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team

Background:. Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a T-cell non-Hodgkin’s lymphoma and an uncommon risk of textured breast implants. Over the past decade, concern about BIA-ALCL has been increasing among both patients and surgeons. Patients are seeking a better under...

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Autores principales:	Jade O. Park, MPH, Carmen E. Webb, MA, Claire F. Temple-Oberle, MD, MSc, FRCSC, MMEd
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Surgery RD1-811
Acceso en línea:	https://doaj.org/article/636d93c5baa7439d8d6c17a7263cdcb8
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spelling	oai:doaj.org-article:636d93c5baa7439d8d6c17a7263cdcb82021-11-25T07:57:34ZSupporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team2169-757410.1097/GOX.0000000000003843https://doaj.org/article/636d93c5baa7439d8d6c17a7263cdcb82021-10-01T00:00:00Zhttp://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003843https://doaj.org/toc/2169-7574Background:. Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a T-cell non-Hodgkin’s lymphoma and an uncommon risk of textured breast implants. Over the past decade, concern about BIA-ALCL has been increasing among both patients and surgeons. Patients are seeking a better understanding of their BIA-ALCL risk toward identifying a personalized care plan. This quality improvement project examines the value added by pairing group-based patient education seminars with one-on-one consults. Methods:. Individual consults were held following educational group seminars. Consult field notes underwent qualitative thematic analysis. Themes were cross referenced against a quantitative chart review of patient BIA-ALCL prophylaxis decisions over time. Results:. Four key themes were identified: weighing, perceiving, guiding, and supporting. Weighing considers the risk-benefit assessments patients make when weighing their BIA-ALCL risk. Perceiving describes the underlying psychosocial factors that frame patient perceptions of BIA-ALCL risk. Guiding presents the levels of guidance that patients require when making BIA-ALCL prophylaxis decisions. Supporting explores the therapeutic value of the individual consult. Ultimately, 41% of post-seminar consult attendees sought explantation, compared with 4% among patients who did not participate in this program (P < 0.001). Conclusions:. Key lessons include the following: (1) patients weigh BIA-ALCL risk against perceived surgical risks and the value of their reconstruction; (2) patients can benefit from a personalized balance of autonomy and surgeon guidance when selecting a BIA-ALCL prevention plan; (3) surgeons should seek to understand the psychosocial factors that may underlie patient perceptions of BIA-ALCL risk; and (4) individual consults can be therapeutic and help strengthen the patient–surgeon relationship.Jade O. Park, MPHCarmen E. Webb, MAClaire F. Temple-Oberle, MD, MSc, FRCSC, MMEdWolters KluwerarticleSurgeryRD1-811ENPlastic and Reconstructive Surgery, Global Open, Vol 9, Iss 10, p e3843 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgery RD1-811
spellingShingle	Surgery RD1-811 Jade O. Park, MPH Carmen E. Webb, MA Claire F. Temple-Oberle, MD, MSc, FRCSC, MMEd Supporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team
description	Background:. Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a T-cell non-Hodgkin’s lymphoma and an uncommon risk of textured breast implants. Over the past decade, concern about BIA-ALCL has been increasing among both patients and surgeons. Patients are seeking a better understanding of their BIA-ALCL risk toward identifying a personalized care plan. This quality improvement project examines the value added by pairing group-based patient education seminars with one-on-one consults. Methods:. Individual consults were held following educational group seminars. Consult field notes underwent qualitative thematic analysis. Themes were cross referenced against a quantitative chart review of patient BIA-ALCL prophylaxis decisions over time. Results:. Four key themes were identified: weighing, perceiving, guiding, and supporting. Weighing considers the risk-benefit assessments patients make when weighing their BIA-ALCL risk. Perceiving describes the underlying psychosocial factors that frame patient perceptions of BIA-ALCL risk. Guiding presents the levels of guidance that patients require when making BIA-ALCL prophylaxis decisions. Supporting explores the therapeutic value of the individual consult. Ultimately, 41% of post-seminar consult attendees sought explantation, compared with 4% among patients who did not participate in this program (P < 0.001). Conclusions:. Key lessons include the following: (1) patients weigh BIA-ALCL risk against perceived surgical risks and the value of their reconstruction; (2) patients can benefit from a personalized balance of autonomy and surgeon guidance when selecting a BIA-ALCL prevention plan; (3) surgeons should seek to understand the psychosocial factors that may underlie patient perceptions of BIA-ALCL risk; and (4) individual consults can be therapeutic and help strengthen the patient–surgeon relationship.
format	article
author	Jade O. Park, MPH Carmen E. Webb, MA Claire F. Temple-Oberle, MD, MSc, FRCSC, MMEd
author_facet	Jade O. Park, MPH Carmen E. Webb, MA Claire F. Temple-Oberle, MD, MSc, FRCSC, MMEd
author_sort	Jade O. Park, MPH
title	Supporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team
title_short	Supporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team
title_full	Supporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team
title_fullStr	Supporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team
title_full_unstemmed	Supporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team
title_sort	supporting women’s bia-alcl decision-making: role of the individual consult in empowering the patient–physician team
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/636d93c5baa7439d8d6c17a7263cdcb8
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Supporting Women’s BIA-ALCL Decision-making: Role of the Individual Consult in Empowering the Patient–Physician Team

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