The Cultural and Social Determinants of Breast Reconstruction: A Systematic Review.

BACKGROUND

The decision-making process for a patient to undergo breast reconstruction after mastectomy is complex and dependent on personal, cultural, and religious values. This systematic review explores the cultural influences on the patient's decision to undergo breast reconstruction that have been reported in the literature.

METHODS

A systematic search was conducted on March 14, 2025, using Embase, PubMed, Medline, Web of Science, and CINAHL. Inclusion criteria required the focus on cultural preferences and values regarding breast reconstruction during patient clinical experiences. Two investigators independently conducted the screening, extraction, and synthesis of results.

RESULTS

Of the 1419 reports identified, eight articles were selected for analysis. The total number of patients across the review was 1,733. The average study sample size was 217 patients, with a range from 8 to 715 patients. The patient groups represented women from distinct ethnic or racial backgrounds as well as speakers of various languages: Chinese women, Hispanic women, African American women, women of Belgian nationality, Vietnamese-speaking women, Arabic-speaking women, and English-speaking women. Despite various measures and scales being used, all included studies depicted the patients' experiences, challenges, and strategies to navigate decision-making regarding breast reconstruction, which included these core factors: empowered and informed choices, self-advocacy, community, and maintaining physical as well as mental health. Of the studies that reported, 85 (5%) of patients decided to undergo breast reconstruction.

CONCLUSION

Understanding the preferences of women of various cultural backgrounds regarding breast reconstruction is essential to ensure culturally relevant and informed patient-centered care.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .