Psychosocial well-being at time of diagnosis of breast cancer affects the decision whether or not to undergo breast reconstruction

Abstract

Objectives: Numerous studies have shown that breast reconstruction after mastectomy improves QoL in breast cancer survivors. However, still about half of the patients does not opt for reconstruction. In order to accommodate suitable counseling, we should elucidate the factors that play a role in the decisionmaking process. This study aimed to evaluate the influence of QoL, among women diagnosed with breast cancer before the start of any treatment, on their decision whether or not to undergo breast reconstruction. Materials and methods: BREAST-Q surveys were provided to breast cancer patients at the specialized breast care outpatient clinic after their first consultation with a surgical oncologist, between June 2017 and March 2019. The Q-scores of the subdomains physical well-being, psychosocial well-being, sexual well-being, and satisfaction with breasts of patients that underwent mastectomy were statistically analyzed. Results: Sixty-seven patients, undergoing mastectomy, completed the questionnaire. Fifty-four percent received reconstructive surgery. Mean age of patients seeking breast reconstruction was significantly lower than patients who did not opt for a reconstruction (53.5 vs. 63.7). Mean follow-up after mastectomy was 18.1 months. Except for satisfaction with breasts, mean Q-scores were higher in the group of patients who did not choose for reconstructive surgery. Psychosocial well-being was significantly higher in the non-reconstruction group (p ¼ 0.012). Conclusions: Psychosocial well-being at time of diagnosis of breast cancer was significantly higher in patients refraining from breast reconstructive surgery after mastectomy. Psychosocial characteristics might be essential for the decision-making process as well. Further prospective research should evaluate this.

Well-Being, Depression, and Anxiety following Oncoplastic Breast Conserving Surgery versus Modified Radical Mastectomy Followed by Late Breast Reconstruction

“…The reasons why so many patients refuse this medical procedure remain largely unclear. In addition to certain demographic characteristics, the stage of the tumor, and the incomplete or substandard information provided by the attending physician, there are data in the literature that suggest that the psychological profile of the woman may play a decisive role in their decision regarding the reconstruction procedure [19].…”

Body image experience of women with breast cancer: A meta‐synthesis

“…Similarly to this review, a study previously published in the literature described the experience of initial aversion to the reconstructed breast [80]. Evidence in the literature indicates that, although breast reconstructive surgery contributes to the resignation of body image, reconstruction is not enough to restore the emotional well‐being of women with breast cancer [81, 82].…”

Comparison of Body Image and Body Exposure During Sexual Activity and Sexual Assertiveness Among Mastectomized Women with/Without Mammaplasty and Mammaplasty Volunteer Patients

“…Women seeking mammaplasty are more sexually con-scious, interested, and active and pay more attention to breast shape and sexuality (45). The women undergoing mammaplasty are more preoccupied with how their bodies are evaluated than mastectomized women who do not intend to undergo mammaplasty.…”