A retrospective investigation of women’s experience with breast reconstruction after mastectomy

Ditsch, Nina; Bauerfeind, Ingo; Vodermaier, Andrea; Tripp, Christina; Löhrs, Bettina; B, Toth; Himsl, Isabelle; Graeser, Monika; Harbeck, Nadia; Lenhard, M.

doi:10.1007/s00404-012-2590-1

Cited by 16 publications

(15 citation statements)

References 34 publications

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“…These results are consistent with qualitative literature reporting that attractiveness, femininity concerns, and feeling whole again are primary motivations for choosing BR. 19,34 For the majority of women who had partners, the partner was not a key influence on the BR decision, and BR was not viewed as a way to restore their sexual relationships or help women forget about having breast cancer. The restoration of intimacy has not been a common motivation for BR noted in the prior qualitative literature.…”

Section: Discussionmentioning

confidence: 99%

Attitudes and Decisional Conflict Regarding Breast Reconstruction Among Breast Cancer Patients

et al. 2016

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Background The decision to undergo breast reconstruction (BR) surgery following mastectomy is made during stressful circumstances. Many women do not feel well-prepared to make this decision. Objective Using the Ottawa Decision Support Framework, this study aimed to describe women’s reasons to choose or not choose BR, BR knowledge, decisional preparedness, and decisional conflict about BR. Possible demographic, medical, BR knowledge, and attitudinal correlates of decisional conflict about BR were also evaluated. Methods Participants were 55 women with early stage breast cancer drawn from the baseline data of a pilot randomized trial evaluating the efficacy of a breast reconstruction decision support aid for breast cancer patients considering BR. Results The most highly-ranked reasons to choose BR were the desire for breasts to be equal in size, the desire to wake up from surgery with a breast in place, and perceived bother of a scar with no breast. The most highly-ranked reasons not to choose BR were related to the surgical risks and complications. Regression analyses indicated that decisional conflict was associated with higher number of reasons not to choose BR and lower levels of decisional preparedness. Conclusions The results suggest that breast cancer patients considering BR may benefit from decisional support.

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Section: Discussionmentioning

confidence: 99%

Attitudes and Decisional Conflict Regarding Breast Reconstruction Among Breast Cancer Patients

et al. 2016

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“…3,4,5,6,7,8,9 However, much of this research is outdated, problematic, or both. The majority of studies on the subject have relied on retrospective questionnaires.…”

Section: Discussionmentioning

confidence: 99%

“…Reported proportions of women not undergoing nipple reconstruction vary widely, from near 10% 6 to 50% 7 and even higher. 1,8 However, no studies have examined factors associated with lack of NAC reconstruction. The authors of the present study aimed to measure the prevalence of lack of NAC reconstruction and evaluate associated factors.…”

Section: Introductionmentioning

confidence: 99%

The Necessity of the Nipple

Weissler

Schnur²,

Lamelas³

et al. 2017

Annals of Plastic Surgery

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Introduction Satisfaction with breast reconstruction is thought to be greatest among patients who complete nipple and areolar-complex (NAC) reconstruction. Anecdotally, many patients are known to decline NAC reconstruction. The authors aimed to characterize the epidemiology of and factors associated with incomplete breast reconstruction. Methods Breast reconstruction patients with follow-up in a single institution's electronic medical record system were reviewed. Chi-squared and independent t-tests were used to identify variables associated with lack of NAC reconstruction; associated variables (p<0.05) were used to build a binary logistic regression. Results Four hundred thirty-three patients were reviewed. Reconstructions consisted of an average of 4.0±2.0 procedures over 503 (range 2-3,652) days. One hundred twelve patients had NAC reconstruction or tattooing (25.9%) and 73 (17.6%) had both – 226 women (54.6%) had neither. On multivariate analysis, a history of any implant removal was associated with a 93.4% decreased chance of NAC reconstruction (p=0.002), while prophylactic or early stage mastectomy was associated with 52.9% increased chances of NAC reconstruction (p=0.009). Conclusions Over half of the present cohort did not complete any NAC reconstruction. Patients with later-stage cancer and a history of implant removal were less likely to have NAC reconstruction. The high prevalence of incomplete reconstructions suggests that the classical definition of breast reconstruction completion as requiring NAC reconstruction may be outdated or not applicable to all populations. Instead, “completion” should be considered a subjective determination varying between patients.

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“…Alrededor de un 50% de estas pacientes experimenta niveles elevados de malestar emocional, que incluye síntomas de ansiedad y depresión (1,2) y peor calidad de vida (2)(3)(4)(5)(6) . A pesar de que, en todos los casos que es factible se efectúa un tratamiento conservador, en un 30-50% de mujeres con cáncer de mama la mastectomía sigue siendo el tratamiento indicado (2,7) , por lo que, en muchos casos, al impacto del diagnóstico de cáncer se suma la necesidad de que el tratamiento quirúrgico de elección sea la mastectomía (7) .…”

Section: Introductionunclassified

“…A pesar de que, en todos los casos que es factible se efectúa un tratamiento conservador, en un 30-50% de mujeres con cáncer de mama la mastectomía sigue siendo el tratamiento indicado (2,7) , por lo que, en muchos casos, al impacto del diagnóstico de cáncer se suma la necesidad de que el tratamiento quirúrgico de elección sea la mastectomía (7) . El diagnós-tico de cáncer de mama confronta a las mujeres de todas las edades con ansiedad relacionada con su apariencia, su atractivo, su sexualidad y su auto-estima (5,8,9) . Por esta razón, la reconstrucción mamaria se plantea como una opción a considerar para las mujeres sometidas a mastectomía.…”

Section: Introductionunclassified

Reconstrucción inmediata en cáncer de mama. ¿Las mujeres están satisfechas con su decisión?

López¹,

Fernández²,

Rodríguez³

et al. 2016

Psicooncología

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¡ResumenObjetivo: Conocer las vivencias, expectativas y satisfacción percibida de un grupo de mujeres diagnosticadas de cáncer de mama con mastectomía con reconstrucción en el mismo acto quirúrgico.Material y Métodos: La metodología utilizada en esta investigación ha sido la cualitativa y las técnicas para la recogida de la información fueron la entrevista en profundidad (cuatro mujeres) y el grupo focal (dos grupos de 8 pacientes cada uno).Resultados: se exploraron cinco áreas 1) El impacto del diagnóstico del cáncer 2) Información recibida ante la intervención 3) Las experiencias en el postoperatorio. 4) Cumplimiento de expectativas y 5) Satisfacción con la decisión tomada. El diagnóstico fue impactante para la mayoría de las mujeres. Inicialmente, la información recibida se consideró buena y suficiente pero hemos comprobado que posteriormente, una vez superada la convalecencia de la intervención, aparecen más quejas sobre todo relacionadas con las complicaciones posteriores y con el dolor. Las expectativas sobre la reconstrucción inmediata estuvieron muy ligadas con los resultados estéticos finales. Algu- AbstractObjective: To know the experiences, expectations and perceived satisfaction in a group of breast cancer women who had undergone immediate breast reconstruction after mastectomy.Material and Methods: 20 women took part in a qualitative study. 4 women were assessed through an in-depth interview and the other 16 women were divided into two focus groups (8 each). The recorded interview and focus group discussions were transcribed and analyzed using "framework analysis".Results: Five areas were explored: 1) Impact of cancer diagnosis, 2) Information received about the surgery, 3) Post-surgery experiences, 4) Fulfilment of expectations and 5) Satisfaction with the decision. Cancer diagnosis was overwhelming for most of the women. For women, information received was considered good and sufficient, but the study shows that after the post-surgical period, more complaints related to pain and other complications appear. The expectations about immediate breast reconstruction were linked with the final aesthetic results. Some women would choose to do the same procedure again despite the Financiación: El actual trabajo ha recibido una beca de la Fundación Victor Grifols i Lucas

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A retrospective investigation of women’s experience with breast reconstruction after mastectomy

Abstract: A significant association of patient satisfaction with postoperative complications and the decision for a re-reconstruction was demonstrated. Furthermore, our results emphasize the importance of detailed preoperative counseling for women's adjustment to reconstructive surgery.

Cited by 16 publications

References 34 publications

Attitudes and Decisional Conflict Regarding Breast Reconstruction Among Breast Cancer Patients

Attitudes and Decisional Conflict Regarding Breast Reconstruction Among Breast Cancer Patients

The Necessity of the Nipple

Reconstrucción inmediata en cáncer de mama. ¿Las mujeres están satisfechas con su decisión?

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