The researchers examined the goals and expectations women themselves express before breast reconstruction. The findings show that the same operation can carry different meanings depending on a woman’s life situation, experiences, and what she hopes the reconstruction will lead to. This makes it easier for healthcare professionals to provide more precise information, discuss possible trade-offs, and reason together with the patient about which option is most appropriate.
Two women may choose the same method, but have completely different hopes about what the operation will give them
More than a question of surgical method
Women who underwent preventive surgery to reduce the risk of breast cancer more often emphasised aesthetic wishes, while women who had lived without a breast for some time before reconstruction more often described practical goals, such as avoiding the need to manage an external prosthesis, being freer in their choice of clothes, and living an active life without limitations. Among women who underwent surgery in connection with cancer treatment, reconstruction more often concerned regaining normality, function, and everyday life after illness and treatment.
“The most important finding is that breast reconstruction means different things to different women,” says Anna Paganini, Associate Professor in Nursing at the University of Gothenburg and first author of the study.
The material also included recurring themes related to identity, femininity, self-esteem, and the feeling of becoming whole again.
“Two women may choose the same method but have completely different hopes about what the operation will give them. If healthcare professionals do not know what matters most to the individual woman, there is a risk that they will end up talking at cross purposes,” says Anna Paganini.
Support for clarifying goals
These findings are the first to emerge from GoBreast2, a larger study funded by the Swedish Cancer Society, in which caring science research is a central component. The project uses PEGASUS, a method that helps women formulate their own goals and expectations before breast reconstruction.
The method has been translated from English and adapted to the Swedish healthcare context. Today, women referred for breast reconstruction are offered a digital meeting with a specialist nurse before meeting the surgeon.
“The main benefit of PEGASUS is that the woman is given time to reflect and articulate what matters most before meeting the plastic surgeon,” says Anna Paganini.
The hope is that this way of working will contribute to more person-centred conversations, in which the woman’s own goals become a clear part of the counselling before reconstruction. This may make it easier to manage expectations and to choose a path that feels meaningful to the patient while also being surgically feasible.
“When a woman’s own goals become clear, it becomes easier to provide individually tailored information, discuss possible trade-offs, and together arrive at the option that is most reasonable for her,” Anna Paganini concludes.
