Demand for Plastic Surgical Operations after Primary Breast Cancer Surgery

Abstract

Background and Aims:The aim of this study is to evaluate the demand for plastic operations after primary breast cancer surgery. In addition, this study aims to increase knowledge on factors affecting the wish of women for breast reconstruction.Material and Methods: A questionnaire was sent to some 111 patients who had undergone either mastectomy or breast conserving surgery. The response rate was 76 %. The questionnaire consisted of 20 structured questions. The data was analysed statistically using the t test and the chi-square test.Results: 28 % of the mastectomized patients wanted a breast reconstruction. Factors found to affect the patient's wish for reconstruction were age ( p <0.001) and whether the patient had received radio-( p <0.05) or chemotherapy ( p <0.05). A difference was found between the mastectomy group and the breast conserving surgery group as to satisfaction in the general ( p <0.05) and the cosmetic ( p <0.05) outcome of the surgery, as well as patient's expectations regarding the outcome ( p <0.01).Conclusions: Rather fewer mastectomized patients wanted a reconstruction. The proportion, however, grew significantly larger in the younger age groups. This study also shows that receiving radio-or chemotherapy seems to predict a woman's choice against a reconstruction. Patients who receive radio-or chemotherapy may consider their illness more severe and life-threatening than those not receiving such treatments.

Propiedades Psicométricas del Cuestionario de Motivos a Favor y en Contra de la Reconstrucción Mamaria

“…Al igual que en estudios previos (14,16,43) , el estado civil fue independiente de los motivos a favor o en contra de la RM. El hecho de que la frecuencia de relaciones sexuales actuales sean independientes de los motivos a favor o en contra de la RM, pero no la frecuencia de relaciones sexuales antes del diagnóstico es concordante con la hipótesis de que el deseo de reanudar la vida sexual es un motivo a favor de la RM con independencia del estado civil (2,44) .…”

“…En la actualidad existe una amplia gama de opciones de RM; no obstante, las tasas de estas cirugías siguen siendo muy bajas en todos los países. La tasa es del 12% en Australia (5) , 16,5% en Inglaterra (6) , 18,6% en Colombia (7) , 21-29,2% en Estados Unidos (8,9) , 21% en Suecia (10) y 32,1% en Francia (11) . En México, no se cuenta con suficientes datos, pero se estima que el porcentaje es ínfimo.…”

“…Los motivos por los cuales las mujeres con mastectomía se realizan o no la RM han sido estudiados desde finales de los noventas (13) , y estas investigaciones han ido en aumento con mayor ímpetu en países de la Unión Europea (11,(14)(15)(16)(17) . Los resultados son similares a lo largo del tiempo.…”

“…Dichos estudios han desarrollado instrumentos para medir los motivos por los cuales las mujeres con mastectomía se someten o no a una RM. Sin embargo, estos se han creado exclusivamente para cumplir con los objetivos de su estudio, sin pretender validar los mismos (11,(14)(15)(16)(17)(18) . Por ejemplo, Hequet et al (11) y Zieliński et al (17) desarrollaron cuestionarios de opción múltiple para conocer los motivos por los cuales las mujeres con mastectomía decidieron no realizarse la RM.…”

Motives for the choice of not undergoing breast reconstruction

“…In another study, for most of the women the reason for making the decision to undergo breast reconstruction is the willingness to maintain normal physical appearance [23]. Meretoja gives the following main reasons for the decision to undergo breast reconstruction for women in Finland: problems with one's body image, inconvenience connected with wearing the prosthesis or inability to accept it, low self-esteem, willingness to forget about the cancer, and doctor's recommendations [24]. In a study carried out by Harcourt, the reasons for making the decision about breast reconstruction for 103 surveyed women were: the importance of their own body image, self-esteem, understanding of the essence of cancer and of the surgical procedure of breast reconstruction, the sense of gaining self-control, demographic and social indicators, the opinion of the environment, including the medical personnel, and the hospital in which the surgery was performed (including procedures and waiting time) [25].…”