Table 1.
Overview and brief summary of the pDA’s modules
| Module | Description of module |
|---|---|
| 1. Diagnosis | Based on patient’s treatment options as provided to them by their clinician during the clinical encounter, patients tailor the pDA to their situation (i.e. whether or not the patient is eligible for nipple-sparing surgery, whether or not radiotherapy is or might be necessary following surgery, and whether or not the patient is eligible for BCS). |
| 2. Immediate reconstruction or not (yet)? |
Breast reconstruction options and their pros and cons are described. Options include undergoing immediate breast reconstruction, undergoing delayed breast reconstruction, and undergoing no breast reconstruction. Information is structured as answers to the following questions: ‘What choices do I have?’, ‘What are my options?’, ‘What are the pros and cons?’, ‘How much time do I have to think?’, ‘A period without a breast?’, ‘Sparing my skin and nipple?‘a, ‘When can I resume my normal activities?’, ‘When is breast reconstruction finished?’, ‘What is breast-conserving surgery?‘b |
| 3. Expectations |
Information about what patients can expect from undergoing breast reconstruction is provided. Also, the different types of breast reconstruction and their pros and cons are described. Options include implant-based breast reconstruction and autologous breast reconstruction. Information is structured as answers to the following questions: ‘What can I expect of a new breast?’, ‘What are the pros and cons of implant-based and autologous breast reconstruction?’, ‘What if I received breast radiation in the past?’, ‘What is implant-based breast reconstruction?’, ‘What is autologous breast reconstruction?’, ‘How will my breast look like?’, ‘How will my breast feel like?’, ‘Will this impact my body image?’, ‘What are potential complications?’, ‘What if I need breast radiation following surgery?‘c |
| 4. Considerations |
With value clarification exercises, women are actively encouraged to weigh the options of undergoing immediate breast reconstruction or not undergoing breast reconstruction (and potentially undergoing delayed breast reconstruction). Furthermore, women are invited to indicate their breast reconstruction preference and note questions they have for their plastic surgeon. |
| 5. Patient stories | Short stories of six women who underwent breast surgery with or without breast reconstruction. The stories illustrate the experiences of these women with decision making about breast reconstruction and the impact of their decision on their daily life. |
| 6. Summary | A summary sheet (A4 format), including patient’s personal considerations, preferences and questions for the plastic surgeon. The sheet can be saved as PDF and printed. Patients are encouraged to discuss the summary sheet with their plastic surgeon. |
aText of this section is rephrased dependent on whether or not patient is eligible for nipple-sparing surgery
bOnly shown if the patient is eligible for BCS
cOnly shown if radiotherapy is or might be needed