Health-related quality of life assessment after breast reconstruction

Potter, Shelley; Thomson, H. J.; Greenwood, Rosemary; Hopwood, Penelope; Winters, Zoë

doi:10.1002/bjs.6605

Cited by 49 publications

(39 citation statements)

References 30 publications

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“…Si las mujeres consideran la apariencia física como aspecto muy importante en su vida, tendrán más alto nivel de estrés ante el CaMa (Baxter et al, 2006) y, como los instrumentos para detectar niveles de calidad de vida no siempre son sensibles a todos los aspectos (Potter, Thompson, Greenwood, Hopwood, & Winters, 2009), se debe evaluar la IC a través instrumentos específicos, a fin de detectar estas afectaciones que pueden ser desapercibidas por el equipo médico, y crear alternativas de intervención psicooncológica para mejorar la calidad de vida de las pacientes. Especialmente, se debe seguir investigando en las mujeres latinoamericanas aspectos relacionados con la sexualidad y las relaciones de pareja, dado que se reflejan aún tabúes sobre esta problemática.…”

Section: Alcances Y Limitaciones De La Revisiónunclassified

Evaluación de la imagen corporal en mujeres con cáncer de mama: una revisión sistemática

Varela

Sierra

Heredia³

et al. 2017

Univ Psychol

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RESUMENLa imagen corporal (IC) es la representación subjetiva de la percepción, evaluación, valoración y vivencia del cuerpo que proporciona el sentido de sí mismo como una totalidad. Es afectada cuando existen enfermedades oncológicas que implican cambios corporales. En esta revisión sistemática se identificaron instrumentos susceptibles de usarse en Latinoamérica para evaluar la IC de mujeres con cáncer de mama, analizando 34 artículos publicados en inglés y español del periodo 2004-2014 en bases de libre acceso. Instrumentos originados en Europa y Estados Unidos, tales como la Escala de Imagen Corporal de Hopwood y el módulo QLQ BR 23, desarrollado por la Organización Europea para Investigación y Tratamiento en Cáncer (EORTC), con buenas características psicométricas de validez y confiabilidad, se han utilizado en población latinoamericana. Se valora cómo la IC de mujeres con cáncer de mama afecta su sexualidad, las relaciones de pareja, su autoestima, los estilos de afrontamiento y calidad de vida.Palabras clave cáncer; evaluación; imagen corporal; instrumentos psicométricos. ABSTRACTBody image is the subjective representation of perception, evaluation, assessment and experience of the body that provides the sense of self as a whole. It is affected when passes through diseases, especially when implies physical changes like oncologic diseases.This systematic review identified instruments to assess body image in women with breast cancer, through the analysis of 34 articles published in English and

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Section: Alcances Y Limitaciones De La Revisiónunclassified

Evaluación de la imagen corporal en mujeres con cáncer de mama: una revisión sistemática

Varela

Sierra

Heredia³

et al. 2017

Univ Psychol

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“…Although many studies investigated the psychosocial impact of BR after mastectomy, only few, mostly retrospective studies, focused on the effects of complications and subsequent surgery on psychological distress [10,13,14,15,16]. One retrospective quantitative study ( n = 60) covering a very short follow-up period of three months after surgery, reported that psychological distress levels were similar for women with and without complications [14].…”

Section: Introductionmentioning

confidence: 99%

“…One retrospective quantitative study ( n = 60) covering a very short follow-up period of three months after surgery, reported that psychological distress levels were similar for women with and without complications [14]. Two qualitative studies in very small samples ( n = 6, and n = 21) found that women were unprepared for the BR course, that they felt it was burdensome physically as well as emotionally, and that the additional operations and the long recovery period were disappointing and unexpected, regardless of complications [10,15].…”

Section: Introductionmentioning

confidence: 99%

Most women recover from psychological distress after postoperative complications following implant or DIEP flap breast reconstruction: A prospective long-term follow-up study

et al. 2017

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BackgroundSubstantial complication rates after postmastectomy breast reconstruction (BR) in breast cancer patients have been reported. Few studies have reported on the resulting psychological distress (PD) and satisfaction with the aesthetic result in relation to postoperative complications after completion of implant or DIEP flap BR. The present study investigated whether women were able to recover from complication related distress in the long term.MethodsPD was prospectively measured using questionnaires regarding anxiety, depression and cancer distress. Eligible patients completed questionnaires before BR (T0, n = 144), after one month (T1, n = 139) and after completion of BR, approximately 21 months after initial reconstructive surgery (T2, n = 119). Satisfaction with the aesthetic result was assessed 21 months after BR. Data concerning complications, subsequent additional surgery and total reconstruction failure up to T2 were collected from the medical records. Analyses were performed using multi-level regression analyses correcting for age.ResultsOne or more complications occurred in 61 patients (42%) and 50 women required subsequent surgery (35%). In time, mean PD significantly declined towards baseline scores independent of complications. However, a total reconstruction failure (n = 10) was significantly associated with a large temporary increase in depression scores. After additional surgery due to complications patients were less satisfied with aesthetic outcome, although patient satisfaction was independent of PD.ConclusionsPD outcomes generally declined to normal levels after completion of the entire BR course. Patients experiencing a total reconstruction failure reported more depression after this loss, but in the long term recovered to the same level as women without complications. These findings indicate that women generally can cope efficiently with these serious adverse events, even if they were less satisfied with the aesthetic result.

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“…In fact, evidence suggests that women underestimate what their quality-of-life will be without reconstruction, and overestimate its benefits (Waljee, et al, 2011). In a systematic review of patient-reported outcomes after breast surgery, the majority of studies did not find significant differences in assessment of quality-of-life, or more specific measures of body image or sexuality/sexual functioning between women with mastectomy-alone or reconstruction (see Lee et al, 2009), although this research has been limited by the lack of valid and reliable breast surgery outcome measures (Pusic et al, 2007; Potter, Thomson, Greenwood, Hopwood, & Winters, 2009). Nonetheless, higher quality, prospective comparative studies such as Harcourt et al (2003) (included in Lee et al’s 2009 review), as well as Parker et al (2007), reveal similar patterns of adjustment across surgical groups, with adjustment in all groups improving over time.…”

Section: Introductionmentioning

confidence: 99%

‘Use what God has given me’: Difference and disparity in breast reconstruction

Rubin

Chávez

Alderman

et al. 2013

Psychology & Health

115

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African-American women are significantly less likely to undergo postmastectomy breast reconstruction compared White women in the US. These observed differences have been interpreted as evidence of a healthcare disparity. The current study examines breast reconstruction decision-making among African-American women, locating reconstruction decisions in a context of culture, racial inequality, and biomedicalization. Semi-structured interviews were conducted with 27 African-American women who underwent mastectomy for breast cancer to add patient-centred perspectives to existing conceptualizations of racial/ethnic differences in reconstruction. Participants were socio-demographically diverse, and resided in the New York metropolitan area. Data analysis was informed by grounded theory. Spiritually and culturally-informed body ethics often guided surgery decisions. Participants expressed reservations about breast implants, preferring autologous procedures that use “what God has given.” For some, breast reconstruction restored a sense of normalcy after cancer; others challenged an imperative to reconstruct. Several participants redirected our focus on access to reconstruction toward access to alternatives, noting the low reimbursement for prostheses, or their unavailability in patients' skin tones. We suggest that a framework of “stratified biomedicalization” better addresses the complexities of race, class, and gender that inform preference, access, and recommendations for breast reconstruction, and focuses attention on access to high and lower-tech interventions.

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Health-related quality of life assessment after breast reconstruction

Abstract: Existing HRQL instruments are not sufficiently sensitive to detect clinically relevant problems following breast reconstruction.

Cited by 49 publications

References 30 publications

Evaluación de la imagen corporal en mujeres con cáncer de mama: una revisión sistemática

Evaluación de la imagen corporal en mujeres con cáncer de mama: una revisión sistemática

Most women recover from psychological distress after postoperative complications following implant or DIEP flap breast reconstruction: A prospective long-term follow-up study

‘Use what God has given me’: Difference and disparity in breast reconstruction

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