Clara Lee, MD, MPP, a University of North Carolina at Chapel Hill (UNC) School of Medicine associate professor of surgery and director of research, has received a five-year grant to examine patients’ decision-making process about post-mastectomy breast reconstruction and the effects of reconstruction on quality of life and body image. The $862,700 career development award to the plastic and reconstructive surgeon is from the National Institutes of Health (NIH).
Lee and her colleagues also intend to study some novel psychological aspects of patients’ decisions. “Deciding about breast reconstruction requires a patient to predict how she would feel after the procedure, a process called affective forecasting,” she explained. “Extensive psychological research has shown that people have difficulty making accurate predictions about how they will feel, tending to overestimate the effects of disease and treatments on their well-being and to underestimate their ability to adapt to change and the effects of other aspects of their lives.”
Lee’s research will use a marketing research technique called “conjoint,” or tradeoff, analysis, which, in this case, will be used to better understand women’s preferences about breast reconstruction.
“The decision about whether or not to have breast reconstruction should depend almost completely on a patient’s personal preferences,” Lee said. “And yet we find that rates of breast reconstruction in the United States vary greatly by race, socioeconomic status, and geography.” Her hope is that “this research will eventually lead to more patients receiving the treatments they prefer and ultimately to better quality of life for women with breast cancer.”
Lee will be mentored during the grant period by Michael Pignone, MD, MPH, division chief and associate professor in the Division of General Internal Medicine & Clinical Epidemiology; and Peter Ubel, MD, John O. Blackburn professor of marketing at The Fuqua School of Business, and professor at the Sanford School of Public Policy, Duke University, Durham, North Carolina. Both are national experts in medical decision making.
This article was adapted from materials provided by the University of North Carolina at Chapel Hill.