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Barriers and facilitators to breast reconstruction in ethnic minority women—A systematic review

Xue Ning Lee, Rachel; Yogeswaran, Gowsika; Wilson, Emma; Oni, Georgette

Barriers and facilitators to breast reconstruction in ethnic minority women—A systematic review Thumbnail


Authors

Rachel Xue Ning Lee

Gowsika Yogeswaran

EMMA WILSON EMMA.WILSON@NOTTINGHAM.AC.UK
Professor of Public Health

Georgette Oni



Abstract

Introduction: Post-mastectomy breast reconstruction (PMBR) is an important component of the multidisciplinary care of breast cancer patients. Despite the improved quality of life, significant racial disparities in the receipt of PMBR exist. Given the increasing population of Black, Asian and minority ethnic (BAME) women in UK, it is important to address this disparity. Our review aims to identify the barriers and facilitators influencing the uptake of PMBR in BAME women and raise awareness for physicians on interventions that could improve uptake of PMBR in BAME women.

Methods: The methodology outlined by the Cochrane guidelines was used to structure this systematic review. Systematic searches for qualitative studies on barriers and/or facilitators to PMBR in ethnic women published in English were conducted. The following databases were searched from their inception up to June 2019: MEDLINE, EMBASE, PubMed, Cochrane Library, Google Scholar and Scopus. Reference lists of all included articles and relevant systematic reviews were also hand-searched for possible additional publications. Publication year or status restrictions were not applied. Only full text articles published in English and by peer reviewed journals are included. Exclusion criteria: quantitative studies on barriers and/or facilitators to PMBR, abstracts, conference proceedings, non-English language, non-specific to BAME women. A thematic synthesis approach was used through the development of sub- themes and themes from the findings of the included qualitative studies.

Results: Five studies satisfied the inclusion and exclusion criteria. Three overarching themes emerged from our review: physician-associated factors (physician recommendations), patient-associated factors (knowledge, language, community and cultural, emotions, logistics, patient characteristics) and system-associated factors (insurance coverage, income status).

Conclusion: Our systematic review suggests that there is a paucity of data in the literature on the barriers and facilitators to PMBR in BAME women. Considering the expanding population of BAME women and rising breast cancer incidence, it is imperative that future research in this field is carried out. Physician and patient-associated factors were identified as the most important yet modifiable factors. Adopting a combination of culturally tailored interventions targeting these factors may help improve the access of PMBR in BAME women.

Citation

Xue Ning Lee, R., Yogeswaran, G., Wilson, E., & Oni, G. (2021). Barriers and facilitators to breast reconstruction in ethnic minority women—A systematic review. Journal of Plastic, Reconstructive and Aesthetic Surgery, 74(3), 463-474. https://doi.org/10.1016/j.bjps.2020.10.055

Journal Article Type Article
Acceptance Date Oct 20, 2020
Online Publication Date Nov 5, 2020
Publication Date 2021-03
Deposit Date Nov 10, 2020
Publicly Available Date Nov 6, 2021
Journal Journal of Plastic, Reconstructive and Aesthetic Surgery
Print ISSN 1748-6815
Electronic ISSN 2352-5878
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 74
Issue 3
Pages 463-474
DOI https://doi.org/10.1016/j.bjps.2020.10.055
Keywords Barriers, Facilitators, Breast, Reconstruction, BAME, Ethnic
Public URL https://nottingham-repository.worktribe.com/output/5032569
Publisher URL https://www.sciencedirect.com/science/article/abs/pii/S1748681520305520
Additional Information This article is maintained by: Elsevier; Article Title: Barriers and facilitators to breast reconstruction in ethnic minority women—A systematic review; Journal Title: Journal of Plastic, Reconstructive & Aesthetic Surgery; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.bjps.2020.10.055; Content Type: article; Copyright: Crown Copyright © 2020 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.