What does the project involve?
The audit consists of:
- a prospective study to examine the care currently provided to mastectomy and reconstruction patients
- a patient-reported outcomes assessment including quality of life and satisfaction with care
- a survey of all breast, plastic surgery and private units in England and Wales to describe organisation of care
- interviews with experts in the field to investigate attitudes to reconstruction and identify strengths and weaknesses of the service currently provided
- an analysis of existing data sources to describe recent treatment patterns in mastectomy and breast reconstruction.
The prospective study
The prospective study will include all women undergoing mastectomy (with or without immediate reconstruction) or delayed reconstruction between 1 January 2008 and 31 March 2009. The final deadline for data submission was the May 2009. A paper datasheet for peri-operative clinical data will be enclosed with each set of patient notes, with the following data collected and entered at the Unit level:
- registration, previous treatment, co-morbidity and patient-reported outcomes consent to be collected at pre-assessment clinic or on admission
- operative and reconstructive decision-making to be collected as soon as possible after surgery (ideally in theatre)
- peri-operative morbidity to be collected at discharge
- pathology (post-mastectomy) to be collected at time of discharge letter or post-operative MDT. In the case of delayed reconstruction patients, to be collected with registration data.
Patient-reported outcome questionnaires will subsequently be distributed, collected and analysed centrally by the audit team three and eighteen months after surgery.