Annelotte van Bommel

103 Clinicians’ opinion on immediate breast reconstruction reconstruction did not differ significantly between surgical oncologists and plastic surgeons (97% versus 99%, respectively, P=0.594). This was also true regarding advantages and disadvantages of the timing of reconstruction (97% versus 99%, respectively, P=0.589), and consequences of other therapies such as adjuvant therapy (84%versus 91%, respectively, P=0.130). Forty-eight percent of the surgical oncologists discussed all reconstructive techniques with their patients, versus 85% of the plastic surgeons (P<0.001). The remaining surgical oncologists (52%) tended to discuss only techniques offered at their own institution (29%) or reconstructive techniques that they regarded relevant to the specific patient (23%). Patient related contra-indications Table 2 provides a general overview of factors considered a contra-indication by surgical oncologists and plastic surgeons. Age was not considered a contra- indication for any of the IBR types except age >75 years. Specifically for autologous reconstructions, a considerable percentage of the plastic surgeons (38%) reported age >75 years as contra-indication compared to 19% of the surgical oncologists. For implant reconstructions, older age was less frequently considered a contra- indication by both surgical oncologists (9%) and plastic surgeons (15%) when compared to autologous reconstructions. Smoking was a contra-indication for IBR for surgical oncologists in 60%, 56% and 41% for autologous, combination autologous-implant and implant reconstructions, respectively. These figures were 48%, 45% and 47%, respectively, for plastic surgeons. About 14–17% of the plastic surgeons, depending of the reconstruction technique, reported large breast size (>D-cup) to be a contra-indication compared to 7–8% of the surgical oncologists. No significant differences between reconstruction techniques were found. Approximately 65% of the plastic surgeons and 40% of the surgical oncologists found BMI >40 kg/m 2 a contra-indication for IBR. A BMI <18.5 kg/m 2 was reported as contra-indication by approximately 13–18% of the plastic surgeons compared to approximately 3% of the surgical oncologists. 6