Background:  Patient education is emerging as an increasingly important aspect of modern healthcare.  Both immediate and delayed breast reconstruction have been shown to provide substantial psychosocial benefits for mastectomy patients.  However, lack of knowledge about breast reconstruction has been cited as a major contributing factor in women’s reluctance to undergo breast reconstruction.  Even a cursory overview of educational approaches for breast reconstruction patients reveals a wide variety of objectives, methods, intensity and duration, educators, and content.  This variability suggests a lack of consensus on what works.  The purpose of this study was to formally assess the current state of literature on plastic surgical educational materials for breast reconstruction.

Methods:  A systematic review of the English-language literature was conducted between the years 1966-2006 of all studies pertaining to the use of educational materials for breast reconstruction.  MEDLINE, CINAHAL, PsychINFO, EMBASE, SCOPUS, and the Science Citation Index were searched.  The selection criteria were that the study must employ and evaluate an educational tool for breast reconstruction.  Qualifying studies were assessed for study design, use of a needs assessment, sample size, content, teaching setting, and outcome measure. 

Results:  A total of 496 articles were retrieved from our systematic review.  Of these, only six met criteria.  These studies employed various educational media including written, visual, and audio materials.  Three of the studies were conducted in the United States; two were Canadian in origin; one was conducted in the Netherlands.  Only three of the five studies were randomized controlled trials.    Detailed review revealed that only one study included a needs assessment.  Outcome measures varied:  knowledge gains (n=4), decision to undergo reconstruction (n=3), satisfaction with decision regarding reconstruction (n=1), decisional conflict (n=3), and type of reconstruction (n=3). 

Conclusions:  This review highlights the need for well-designed, methodologically sound research into patient education regarding breast reconstruction that incorporates patient satisfaction as an outcome measure.  Such information is invaluable in developing patient education programs and decision aids that aim at patient empowerment.