45 The Informed Consent Experience for Breast Cancer Surgery and Its Association With Patient Satisfaction

Background

Informed consent is a fundamental ethical and legal requirement to ensure that patients are aware of the risks and benefits of surgical interventions. An effective informed consent process provides adequate information, prioritizes patient comprehension, and facilitates shared decision-making with the goal of optimal patient outcomes and satisfaction.

Objective

We sought to characterize the informed consent process for patients undergoing breast cancer surgery and investigate the extent to which certain elements of the process are associated with patient satisfaction.

Methods

Breastcancer.org visitors and registered online community members in the United States were invited to complete an online survey between August 5 and October 2, 2021. The survey included multiple-choice and rank-order questions about their informed consent and breast cancer surgery experience. All data were deidentified and analyzed in aggregate.

Results

The survey was completed by 2009 adult women diagnosed with breast cancer (mean age, 58 years; 85% White) who had surgery within the past 5 years (mean time since surgery, 17 months). Overall, 42% reported that they were alone when they signed the informed consent form, which was more common during vs before the pandemic (47% vs 34%; P <.05). Patients who were not alone were more likely to report being very/extremely satisfied with their surgical outcomes (61% vs 39%; P <.05). Patients reported being most comfortable when their surgeon was the health care provider who spoke with them before they signed the consent form (91%), as compared with a nurse (79%) or other health care provider (64%). Patients were also more satisfied with surgical outcomes when they felt their surgeons effectively informed them about their surgical options, adequately answered their questions, provided written educational materials, or referred them to reputable online sources. Of patients who were very/extremely satisfied with their surgical outcomes, 92% felt very/extremely well informed at the end of their surgical consultation process.

Conclusions

Patients with breast cancer reported higher satisfaction with surgical decisions when they had a positive informed consent experience that prioritized patient education, comfort, and engagement with the surgeon. This survey highlights the importance of investing in the informed consent process to facilitate shared decision-making for better patient satisfaction with surgical outcomes.

Author Affiliations:

Marisa C. Weiss,¹ Adam Leitenberger,² Frank J. Della Croce,³ Melissa Bollmann Jenkins,⁴ Donna-Marie Manasseh⁵

¹Chief medical officer/founder, Breastcancer.org; Director of Breast Radiation Oncology, Lankenau Medical Center, Wynnewood, PA
²Editorial director, Breastcancer.org.

³Founding partner, Center for Restorative Breast Surgery, New Orleans, LA
⁴Community director, Breastcancer.org
⁵Chief of breast surgery, Maimonides Breast Cancer Center, Brooklyn, NY