Body image problems in women with and without breast cancer 6–20 years after bilateral risk-reducing surgery – A prospective follow-up study

Abstract

To prospectively follow-up and investigate women's perceptions of the cosmetic outcome of their implant-based breast reconstruction, body image, sexuality, anxiety/depressive symptoms, and health-related quality of life (HRQoL) 6e20 years after bilateral risk-reducing mastectomy (RRM), or complementary RRM after breast cancer diagnosis, due to increased risk of hereditary breast cancer. Patients and methods: Women with and without previous breast cancer diagnosis that underwent RRM between March 1997 and September 2010 were invited (n ¼ 200). We compared 146 (73%) sets of longterm questionnaire responses (e.g., EORTC QLQ-BRR26, Body Image Scale, Sexuality Activity Questionnaire, Hospital Anxiety and Depression Scale, and SF-36) with responses one year after surgery. Women with and without previous breast cancer were compared at the long-term assessment point. Results: The HRQoL and anxiety/depressive symptoms remained unchanged compared with one year after surgery, and there were no between-group differences. The negative impact on body image persisted in both groups for most of the items. 'Sexual discomfort' increased significantly for women with previous breast cancer (p ¼ 0.016). Women with previous breast cancer also reported more problems with 'Disease treatment/surgery related symptoms' (p ¼ 0.006) and 'Sexuality' (p ¼ 0.031) in the EORTC QLQ-BRR26 questionnaire. Conclusion: Problems with body image appeared to persist long time post-RRM. No differences in HRQoL were found at the long-term follow-up between women with and without previous breast cancer. The results of this investigation might be of use in improving future counselling before risk-reducing surgery for women in the decision-making process.

Quality of life and patient satisfaction after implant-based breast reconstruction with or without acellular dermal matrix: randomized clinical trial

“…Perhaps more importantly, within the 6‐month follow‐up, none of the participants had an implant exchange 17 . Scores for the reconstruction‐specific module BRR26 were comparable to results reported by Bai and colleagues 30 , who also used EORTC‐BRR26 to evaluate patient‐perceived aesthetics. This prospective follow‐up study 30 assessed long‐term psychosocial outcomes for women with an increased hereditary risk for breast cancer having risk‐reducing mastectomy and IBBR without ADM.…”

“…Third, the reconstruction‐specific tool EORTC QLQ‐BRR26 used in this study was tested for reliability in 2017. However, there is to date only one published paper 30 evaluating results after breast reconstructions using this survey. This makes it difficult to put the present results into a broader context.…”

Patient-reported Outcomes and 3-dimensional Surface Imaging after Risk-reducing Mastectomy and Immediate Breast Reconstruction

“…The majority of these women are young and otherwise healthy and should not only be informed about the possible short-term impact of the surgery on their psychosocial health, but also the long-term effects. 1 , 2 Since the cosmetic results are supposed to be long-lasting, long-term follow-up of women going through risk-reducing surgery may add valuable information to women who are considering the operation.…”

The Relationship Between Illness Perception and Difficulty in Emotion Regulation with the Mediating Role of Quality of Marital Life in Women With Breast Cancer

“…Difficulty in emotion regulation is not a single and homogeneous process, but it is realized through different mechanisms. Difficulty in regulating emotions in different individuals requires activation of some cognitive processes that make the person adopt difficult strategies in regulating different and specific emotions [2]. Regulation of poor emotion regulation or lack of emotional expression can predict premature death due to cancer.…”