Willingness to Undergo Corrective Surgery After Breast-Conserving Surgery in Chinese Patients with Breast Deformities: A Single-Center Study.

Abstract

Objective: To assess willingness to undergo corrective surgery among patients with breast deformities after breast-conserving surgery (BCS) and to identify factors associated with surgical decision-making.

Methods: This single-center cross-sectional study included female breast cancer patients who underwent BCS at Shanxi Bethune Hospital between July 2012 and December 2024, completed adjuvant radiotherapy, and had at least one year of follow-up after radiotherapy. Breast deformity was assessed using the Clough classification. A structured questionnaire evaluated perceived breast appearance, satisfaction, appearance-related distress, willingness toward corrective surgery, reasons for refusal, facilitating factors, and information needs. Willingness was defined as patients' self-reported acceptance of considering corrective surgery at the time of the survey, rather than a confirmed operative plan. Associations were assessed using univariate analyses.

Results: Among 306 patients with post-BCS breast deformities, 123 (40.2%) expressed willingness to undergo corrective surgery and 183 (59.8%) declined. Surgical willingness showed unadjusted associations with several sociodemographic and clinical characteristics, including residence, income, travel time to medical care, deformity grade, postoperative complications, and recurrence/metastasis status. Among patients declining correction, the most important barriers were concern about complications or reconstruction failure (12.3%), financial burden (12.1%), acceptance of current appearance (11.2%), and reluctance to undergo another surgical procedure (10.0%). Among willing patients, the main facilitators were desire to improve body image/self-confidence (16.0%) and physician recommendation (16.0%).

Conclusion: Willingness to undergo corrective surgery after BCS was relatively low and appeared to be shaped by economic burden, risk perception, and appearance-related needs. These findings should be interpreted cautiously because of the single-center cross-sectional design and the absence of multivariable adjustment.