"Are you ready?" A longitudinal interpretative phenomenological analysis of couples' experiences with breast reconstruction decision-making.

Purpose: In this study, we aimed to explore women's and their male partners' experiences with breast reconstruction (BR) decision and to study the evolution of their experiences since undergoing mastectomy to one year after.

Methods: Unstructured individual interviews with four couples facing mastectomy for breast cancer and BR decision-making were conducted following mastectomy (T1) and one year after mastectomy (T2). Longitudinal interpretative phenomenological analysis (LIPA) was conducted on the data.

Results: A total of 16 interviews were conducted, revealing seven group experiential themes: six applicable across time and one related to a specific timepoint. The results highlight two critical aspects: the ambivalence surrounding BR and the perceived importance of moving forward. Women and their partners expressed mixed feelings about BR, weighing the potential for improved quality of life and body image against fears of surgery and medical complications. The decision to undergo BR evolved over time, influenced by experiences related to body acceptance, aesthetic considerations, practical concerns, and societal norms for femininity. Partners played a significant role in the decision-making process, offering emotional support and influencing the decision both directly and indirectly. Moreover, the interpretative accounts underline how couples may see BR as a strategy for repairing both physical and psychological damage.

Conclusion: Our findings emphasize the importance of understanding BR not only as a medical procedure but also as a deeply psychosocial process shaped by individual and relational factors. Furthermore, we provide reflections on the use of LIPA since it is a rarely used method.