Referral Barriers of Post-Mastectomy Patients for Breast Reconstruction among General Surgeons in Yemen

Mastectomy can have a negative impact on a women's self-esteem and sexual health. Breast reconstruction (BR) improves the psychological disorders and quality of life. So, with a low rate of BR in Yemen, we aim to assess the barriers that impede general surgeons from referring post-mastectomy patients for breast reconstruction.

This is a survey study to investigate the general surgeons’ knowledge, attitude, and practice toward BR in Yemen from January to March 2023. The survey was composed of 43 questions and categorized into four primary domains; demographic data, knowledge, attitude, and practice.

The majority of the respondents had good knowledge (80.3%) and attitude (75.4%), yet only 29% of them always discussed BR options with their breast cancer patients. Furthermore, only 16.9% always referred their fit patients to a plastic surgeon. Many surgeons (over 75%) believed that late-stage diagnosis, patient’s priority to treat cancer, lack of multidisciplinary teamwork, poor communication between general and plastic surgeons and financial limitation act as barriers for referral to BR.

The significant perceived barriers to BR in Yemen are lack of multidisciplinary team, late presentation of many breast cancer patients and financial constraints. So, we need to develop guidelines and a simplified referral protocol to facilitate access to breast reconstructive services provided by plastic surgeons.