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Couples’ Experience of the Decision-Making Process in Breast Reconstruction After Breast Cancer

A Lexical Analysis of Their Discourse

Lamore, Kristopher, PhD; Vioulac, Christel, PhD; Fasse, Léonor, PhD; Flahault, Cécile, PhD; Quintard, Bruno, PhD; Untas, Aurélie, PhD

doi: 10.1097/NCC.0000000000000708
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Background One in 3 women with breast cancer will have a mastectomy and face the decision of whether to have breast reconstruction (BR). This decision is shared by the women and their physician, as well as discussed with her partner.

Objective This study aimed to understand the decision-making process of BR through a lexical analysis of the women and their partners' discourse. A secondary aim was to identify the differences between the couples when the woman had, or did not have, BR.

Methods We conducted semistructured interviews with 9 women, and their partners, who underwent a mastectomy after a first episode of breast cancer. A lexical analysis using IRaMuTeQ software was carried out.

Results The analysis yielded 3 classes, each one being more represented by one of the different BR categories. Class 1 contained words reflecting a preoccupation with body modification. Class 2 was related to the surgery and its consequences. Words contained in class 3 were about the couples’ issues regarding surgeries, treatments, and medical care. The question of temporality emerged particularly in classes 2 and 3.

Conclusions This study underlines the differences in the discourse of couples when talking about BR decision-making. Furthermore, it shows the importance of giving women time to think about BR and discuss its issues.

Implication for Practice Decisions about BR are difficult to make and should always be discussed between the women and health professionals, as BR is not always possible or desired by women. Partners need to be included in treatment decision-making.

Author Affiliations: Laboratory of Psychopathology and Health Processes, Paris Descartes University, Boulogne-Billancourt (Drs Lamore, Vioulac, Fasse, and Flahault and Professor Untas); Laboratory Psy-DREPI, University of Burgundy, DIjon (Dr Fasse); Laboratory EA 4136 "Handicap, Activité, Cognition, Santé", University of Bordeaux (Professor Quintard), France.

Correspondence: Kristopher Lamore, PhD, Laboratory of Psychopathology and Health Processes (EA 4057), Paris Descartes University, 71 Avenue Edouard Vaillant, 92100 Boulogne-Billancourt, France (kristopher.lamore@gmail.com).

The authors have no conflicts of interest to disclose.

This work was supported by the Cancéropôle du Sud-Ouest under Grant Emergence 2014, number 2014-E27.

Accepted for publication January 24, 2019.

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