Breast sensibility after bilateral risk-reducing mastectomy and immediate breast reconstruction: A prospective study

Gahm, Jessica; Hansson, Per; Brandberg, Yvonne; Wickman, Marie

doi:10.1016/j.bjps.2013.06.054

Cited by 57 publications

(41 citation statements)

References 21 publications

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“…A majority reported high overall satisfaction with the cosmetic results six months and one year after BRRM, corresponding to their expectations (12). At 2-years follow up, a majority reported pain and discomfort in the breasts, as well as reduced sexual sensations (13,14). Finally, the prospective 2-years follow-up of women with breast cancer who had CRRM showed no adverse effects on HRQoL, emotional distress or sexuality, but some aspects of body image were affected negatively (15).…”

Section: Introductionmentioning

confidence: 75%

“…A collaborative group, consisting of geneticists, oncologists, breast surgeons, plastic surgeons, nurses and a psychologist, was established at the Karolinska University Hospital in 1996 in order to meet the increasing interest in RRM in women at high hereditary risk. A prospective questionnaire study of the expectations on RRM, satisfaction with the result of RRM, emotional reactions, body image, sexuality and HRQoL were conducted, including women who underwent RRM between 1997 and 2010, and the results have been published in a number of papers (4,(10)(11)(12)(13)(14)(15). In conclusion, the results showed that unaffected women, opting for bilateral RRM, reported similar HRQoL levels as a normative population, whereas patients opting for contralateral RRM were comparable to breast cancer patients (10).…”

Section: Introductionmentioning

confidence: 99%

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Preoperative psychosocial characteristics may predict body image and sexuality two years after risk-reducing mastectomy: a prospective study

Unukovych¹,

Johansson²,

Brandberg³

2017

Gland Surg.

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Background: Risk-reducing mastectomy (RRM) in patients at high risk has become more available and the rates of both bilateral (BRRM) and contralateral (CRRM) procedures are increasing. For women opting for RRM, psychosocial well-being, body image and sexuality are known to be important patient-reported outcomes. The aim of the present study was to investigate baseline health-related quality of life (HRQoL) and emotional distress (anxiety and depression) as predictors of body image and sexuality two years after RRM in women undergoing CRRM and BRRM.Methods: This is a prospective cohort study including consecutive women opting for BRRM and breast cancer patients considering CRRM at Karolinska University Hospital during 1998-2010. The women were given a set of questionnaires to be completed at baseline before RRM (The Medical Outcomes Study 36-Item Short Form, The Hospital Anxiety and Depression Scale, and The Sexual Activity Questionnaire) and two years after RRM (all the above-mentioned questionnaires along with The Body Image Scale). Mean scores for all questionnaires were analysed using linear regression models and adjusted for age at RRM as well as calendar year.Results: In total, 253 patients consented to participate in the study. Response rate at baseline and 2 years was 88% and 71%, respectively. In the BRRM group (healthy women), preoperative HRQoL and emotional distress were associated with body image and sexual problems two years after the procedure. No similar associations were found for the patients with breast cancer who underwent CRRM. Conclusions:The current study suggests that preoperative HRQoL and emotional distress may predict body image and sexual problems two years after RRM in healthy women, but not in breast cancer patients.Baseline psychosocial characteristics may be useful to identify women at risk for long-term body image and sexual problems following BRRM, but not among breast cancer patients opting for CRRM.

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Section: Introductionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Preoperative psychosocial characteristics may predict body image and sexuality two years after risk-reducing mastectomy: a prospective study

Unukovych¹,

Johansson²,

Brandberg³

2017

Gland Surg.

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“…1). Four studies were designed as prospective cohort studies [15,23,28,31], and rest were case series [12-14,16-22,24-27,29,30,32,33]. Three studies by Metcalfe et al [16,17,19], two studies by Brandberg et al [23,28], two studies by Gahm et al [21,25] and another three studies by Gahm et al [26,27,32] were each based on same patient populations.…”

Section: Resultsmentioning

confidence: 99%

Quality of life among patients after bilateral prophylactic mastectomy: a systematic review of patient-reported outcomes

Razdan¹,

Patel

Jewell

et al. 2015

Qual Life Res

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Purpose Bilateral prophylactic mastectomy (BPM) is effective in reducing the risk of breast cancer in women with a well-defined family history of breast cancer or in women with BRCA 1 or 2 mutations. Evaluating patient-reported outcomes following BPM are thus essential for evaluating success of BPM from patient’s perspective. Our systematic review aimed to: (1) identify studies describing health-related quality of life (HRQOL) in patients following BPM with or without reconstruction; (2) assess the effect of BPM with or without reconstruction on HRQOL; and, (3) identify predictors of HRQOL post BPM. Methods We performed a systematic review of literature using the PRISMA guidelines. PubMed, Embase, PsycINFO, Web of Science, Scopus and Cochrane databases were searched. Results The initial search resulted in 1082 studies; 22 of these studies fulfilled our inclusion criteria. Post BPM, patients are satisfied with the outcomes and report high psychosocial well-being and positive body image. Sexual well-being and somatosensory function are most negatively affected. Vulnerability, psychological distress and preoperative cancer distress are significant negative predictors of quality of life and body image post BPM. Conclusion There is a paucity of high quality data on outcomes of different HRQOL domains post BPM. Future studies should strive to use validated and breast-specific PRO instruments for measuring HRQOL. This will facilitate shared decision-making by enabling surgeons to provide evidence-based answers to women contemplating BPM.

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“…After mastectomy, breast sensation may be profoundly altered, if not absent entirely [33, *34,35]. To the extent that breasts are an important component of a woman's arousal or a couple's prior “sexual script” [36], this may be a significantly distressing side effect of treatment.…”

Section: Assistance: Review Of Common Problems and How To Helpmentioning

confidence: 99%

How to ask and what to do

Bober

Reese

Barbera

et al. 2016

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review As the number of female cancer survivors continues to grow, there is a growing need to bridge the gap between the high rate of women's cancer-related sexual dysfunction and the lack of attention and intervention available to the majority of survivors who suffer from sexual problems. Previously identified barriers that hinder communication for providers include limited time, lack of preparation, and a lack of patient resources and access to appropriate referral sources. Recent findings This paper brings together a recently developed model for approaching clinical inquiry about sexual health with a brief problem checklist that has been adapted for use for female cancer survivors, as well as practical evidence-based strategies on how to address concerns identified on the checklist. Examples of patient education sheets are provided, as well as strategies for building a referral network. Summary By providing access to a concise and efficient tool for clinical inquiry, as well as targeted material resources and practical health-promoting strategies based on recent evidence-based findings, we hope to begin eliminating the barriers that hamper oncology providers from addressing the topic of sexual/vaginal health after cancer.

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Breast sensibility after bilateral risk-reducing mastectomy and immediate breast reconstruction: A prospective study

Cited by 57 publications

References 21 publications

Preoperative psychosocial characteristics may predict body image and sexuality two years after risk-reducing mastectomy: a prospective study

Preoperative psychosocial characteristics may predict body image and sexuality two years after risk-reducing mastectomy: a prospective study

Quality of life among patients after bilateral prophylactic mastectomy: a systematic review of patient-reported outcomes

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