Annelotte van Bommel

100 differences in care processes between hospitals or physician preferences have been suggested to have a relationship with the use of IBR. 18,23,24 In the Netherlands, every patient diagnosed with breast cancer is discussed in a multi-disciplinary team prior to treatment. The final decision to perform IBR is predominantly made by surgical oncologists and plastic surgeons together with the patient. The surgical oncologist performs the mastectomy (i.e., oncological resection) and the plastic surgeon performs the breast reconstruction thereafter. Physicians’ personal attitudes and the weighing of possible contra-indications may affect this decision-making process. Moreover, the preoperative information given to patients may affect patient preferences. To better understand the existing large variation in the use of IBR and to ultimately improve breast cancer care, it is important to learn about the various attitudes of physicians in the decision-making process of offering patients IBR. Therefore, the aimof the current study was to investigate the practice of preoperative information provision to patients by surgical oncologists and plastic surgeons and their personal opinion towards potential contra-indications for different types of IBR in patients with breast cancer requiring mastectomy. MATERIALS AND METHODS Respondents Surgical oncologists and plastic surgeons with special interest in breast cancer care were identified through clinical networks of theNetherlands Comprehensive Cancer Organization (IKNL) and were invited to participate in a self-administered survey. The responses were collected over an 8-month period from July 2014 to February 2015. To maximize response rates, five reminders were sent approximately after 1.5 months, 3 months, 5 months, 7 months and 7.5 months.