{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:39:11Z","timestamp":1792395551605,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Goldilocks\u2010based breast reconstruction (GBR) offers an autologous, implant\u2010free option for patients seeking breast mound restoration after mastectomy. It is particularly suited for patients with macromastia, ptosis, or significant comorbidities. Despite its growing adoption, limited studies have examined patient understanding and expectations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We interviewed patients who underwent GBR after mastectomy within our institution. Demographic, oncologic, and perioperative data were collected. Semi\u2010structured interviews were conducted to explore patient understanding, decision making process and post\u2010operative experience based on Ottawa Decision Support Framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine participants were included. Mean age was 58.1 years (range: 41\u201371), and mean body mass index was 34.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (range: 24.3\u201346.1). Most participants demonstrated a good understanding of the procedure and why it was offered. Common reasons for selecting this approach were a desire to avoid implants and additional surgeries. Misunderstandings regarding the amount of residual breast tissue, expected postoperative volume, and the need for post\u2010mastectomy surveillance contributed to dissatisfaction. However, decisional regrets were rare.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Motivations for choosing GBR consistently revolve around avoidance of implant placement and desire for single\u2010stage surgery. Common misconceptions regarding the extent of oncological resection and expectations for achievable volume from GBR should be addressed pre\u2010operatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70420","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:39:41Z","timestamp":1792391981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Patient Expectations in Goldilocks\u2010Based Breast Reconstruction: A Qualitative Study Using the Ottawa Decision Support Framework"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3984-4131","authenticated-orcid":false,"given":"Priyanka","family":"Meesa","sequence":"first","affiliation":[{"name":"MedStar Health Department of Plastic Surgery MedStar Health Lymphedema Center of Excellence, Georgetown University of Medicine Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8261-992X","authenticated-orcid":false,"given":"Jing","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Parikh","sequence":"additional","affiliation":[{"name":"MedStar Health Department of Plastic Surgery MedStar Health Lymphedema Center of Excellence, Georgetown University of Medicine Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura K.","family":"Tom","sequence":"additional","affiliation":[{"name":"MedStar Health Department of Plastic Surgery MedStar Health Lymphedema Center of Excellence, Georgetown University of Medicine Washington District of Columbia USA"},{"name":"Division of Plastic and Reconstructive Surgery Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1097\/01.prs.0000246379.99318.74","article-title":"A Prospective Assessment of Surgical Risk Factors in 400 Cases of Skin\u2010Sparing Mastectomy and Immediate Breast Reconstruction With Implants to Establish Selection Criteria","volume":"119","author":"Woerdeman L. A. E.","year":"2007","journal-title":"Plastic and Reconstructive Surgery"},{"issue":"7","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000003708","article-title":"Implant Loss and Associated Risk Factors Following Implant\u2010Based Breast Reconstructions","volume":"9","author":"Blok Y. L.","year":"2021","journal-title":"Plastic and Reconstructive Surgery \u2010 Global Open"},{"issue":"6","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1097\/PRS.0b013e31817151c4","article-title":"Predicting Complications Following Expander\/Implant Breast Reconstruction: An Outcomes Analysis Based on Preoperative Clinical Risk","volume":"121","author":"McCarthy C. M.","year":"2008","journal-title":"Plastic & Reconstructive Surgery"},{"issue":"9","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.ijsu.2012.08.003","article-title":"The Goldilocks Mastectomy","volume":"10","author":"Richardson H.","year":"2012","journal-title":"International Journal of Surgery"},{"issue":"5","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.21037\/gs.2018.07.10","article-title":"Aesthetic Goldilocks Mastectomy and Breast Reconstruction: Promoting Its Use in the Ideal Candidate","volume":"7","author":"Oliver J. D.","year":"2018","journal-title":"Gland Surgery"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.jpra.2025.09.031","article-title":"A Scoping Review of the Goldilocks Mastectomy","volume":"46","author":"Tits L. L.","year":"2025","journal-title":"JPRAS Open"},{"issue":"4","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"35S","DOI":"10.1097\/PRS.0000000000010354","article-title":"Outcomes of the Goldilocks Technique in High\u2010Risk Breast Reconstruction Patients","volume":"152","author":"Ghanouni A.","year":"2023","journal-title":"Plastic & Reconstructive Surgery"},{"issue":"3","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","DOI":"10.1097\/GOX.0000000000002132","article-title":"Toward a More Definitive Goldilocks Mastectomy: Simultaneous Addition of the Lateral Intercostal Perforator Flap","volume":"7","author":"Schwartz J. D.","year":"2019","journal-title":"Plastic and Reconstructive Surgery Global Open"},{"issue":"3","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1111\/tbj.12737","article-title":"Extending the Indications for Autologous Breast Reconstruction Using a Two\u2010Stage Modified Goldilocks Procedure: A Case Report","volume":"23","author":"Schwartz J. C. D.","year":"2017","journal-title":"Breast Journal"},{"issue":"10","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/01.GOX.0000898712.31600.74","article-title":"Results of Modified Goldilocks Procedure as Total Autologous Breast Reconstruction: A Single Surgeon Experience of 275 Consecutive Cases","volume":"10","author":"Grubnik A.","year":"2022","journal-title":"Plastic and Reconstructive Surgery \u2010 Global Open"},{"issue":"8","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1002\/jso.25465","article-title":"Outcomes Analysis of Goldilocks Mastectomy and Breast Reconstruction: A Single Institution Experience of 96 Cases","volume":"119","author":"Chaudhry A.","year":"2019","journal-title":"Journal of Surgical Oncology"},{"issue":"4","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1097\/PRS.0000000000008895","article-title":"Immediate Breast Reconstruction Using the Goldilocks Procedure: A Balance Between More Surgery and Patient Satisfaction","volume":"149","author":"Manrique O. J.","year":"2022","journal-title":"Plastic & Reconstructive Surgery"},{"issue":"6","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1097\/SLA.0000000000001561","article-title":"How Informed Is the Decision About Breast Reconstruction After Mastectomy?: A Prospective, Cross\u2010Sectional Study","volume":"264","author":"Lee C. N.","year":"2016","journal-title":"Annals of Surgery"},{"issue":"1","key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.amjsurg.2018.01.011","article-title":"Association of Shared Decision\u2010Making on Patient\u2010Reported Health Outcomes and Healthcare Utilization","volume":"216","author":"Hughes T. M.","year":"2018","journal-title":"American Journal of Surgery"},{"issue":"4","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0094670","article-title":"Do Interventions Designed to Support Shared Decision\u2010Making Reduce Health Inequalities? A Systematic Review and Meta\u2010Analysis","volume":"9","author":"Durand M. A.","year":"2014","journal-title":"PLoS One"},{"issue":"5","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1177\/0272989X20936209","article-title":"20th Anniversary Update of the Ottawa Decision Support Framework Part 1: A Systematic Review of the Decisional Needs of People Making Health or Social Decisions","volume":"40","author":"Hoefel L.","year":"2020","journal-title":"Medical Decision Making"},{"issue":"4","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1177\/0272989X20924645","article-title":"20th Anniversary Update of the Ottawa Decision Support Framework: Part 2 Subanalysis of a Systematic Review of Patient Decision Aids","volume":"40","author":"Hoefel L.","year":"2020","journal-title":"Medical Decision Making"},{"issue":"3","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1177\/0272989X20911870","article-title":"20th Anniversary Ottawa Decision Support Framework: Part 3 Overview of Systematic Reviews and Updated Framework","volume":"40","author":"Stacey D.","year":"2020","journal-title":"Medical Decision Making"},{"issue":"4","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1177\/0272989X19851346","article-title":"Decisional Conflict Scale Findings Among Patients and Surrogates Making Health Decisions: Part II of an Anniversary Review","volume":"39","author":"Garvelink M. M.","year":"2019","journal-title":"Medical Decision Making"},{"key":"e_1_2_9_21_1","unstructured":"M. J.Jacobsen A. M.O'Connor andD.Stacey Decisional Needs Assessments in Populations: A Workbook for Assessing Patients' and Practitioners' Decision Making Needs (University of Ottawa 1999; updated 2013)."},{"issue":"7","key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"e311","DOI":"10.1016\/S1470-2045(12)70133-X","article-title":"Conservative Mastectomy: Extending the Idea of Breast Conservation","volume":"13","author":"Veronesi U.","year":"2012","journal-title":"The Lancet Oncology"},{"issue":"6","key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"S432","DOI":"10.1097\/SAP.0000000000003952","article-title":"Monitoring for Breast Cancer Recurrence Following Goldilocks Breast Reconstruction","volume":"92","author":"Wang J.","year":"2024","journal-title":"Annals of Plastic Surgery"},{"key":"e_1_2_9_24_1","unstructured":"National Comprehensive Cancer Network NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Version 8. (2026).NCCN.org. Accessed 01\/16\/2026."}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70420","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.70420","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70420","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:39:46Z","timestamp":1792391986000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.70420"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,18]]},"references-count":23,"alternative-id":["10.1002\/jso.70420"],"URL":"https:\/\/doi.org\/10.1002\/jso.70420","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,18]]},"assertion":[{"value":"2026-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jso.70420"}}