The option of delayed reconstructive surgery following mastectomy for invasive breast cancer: Why do so few patients embrace this offer?

Body Image in Younger Breast Cancer Survivors

“…Participants ranged in breast cancer diagnosis from Stages 0 to III and from immediately post-treatment to as many as five years post-treatment. The majority of studies were conducted in the United States (n = 15) 2,7,9,19,31,34,39,42,44,45,47,52,54,55,58 and Europe (n = 13), 26,29,30,33,35,36,38,41,43,48,49,51,57 with the rest being conducted in Australia (n = 5), 8,40,46,50,53 Iran (n = 2), 32,37 and Korea (n = 1). 56 …”

“…Among the most common were the Body Image Scale (BIS) (Cronbach's alpha = 0.93) 4 which was utilized in four studies, 7,8,29,38 the European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality-of-Life Module (EORTC-QLQ-BR23) (Cronbach's alpha 0.70-0.91) 59 used in three studies, 9,39,49 the European Organization for Research and Treatment core Quality of Life Questionnaire (EORTC-QLQ-C30), comprised of multiple subscales, one of which assesses body image (Cronbach's alpha 0.52-0.89), 60 used in one study, 40 and the Cancer Rehabilitation Evaluation System (CARES) (Cronbach's alpha 0.83), 61 which was used in four studies. 2,19,31,56 There were also nine studies that utilized investigator-created or aggregated questionnaires specifically developed for their studies, 33,37,41,42,50,57 three of which were the qualitative studies included in the review. 52-54 …”

“…26,29,33,35-37,39,41,47,52,54,56,57 One qualitative study identified a theme that women wanted age-specific concerns addressed. 52 Other findings included younger women feeling less comfortable during intimacy, 36,37 being more concerned about appearance, 57 being more open to discussions of breast reconstruction, 33,41 experiencing better outcomes related to body image with breast conserving surgery, 29,35,39,47 experiencing improved sexual satisfaction with an intervention for sexuality that also addressed body image, 56 experiencing greater distress related to physical changes due to adjuvant treatment, 54 and younger age being identified as a predictor of worse body image. 26 …”

“…Surgery type was found to have an impact on appearance satisfaction in seven of the studies. 7,29,31,39,43,47,51 Younger women were found to be more likely to opt for breast reconstruction, 36,41 women under age 60 that underwent reconstruction were found to have better body image than those under age 60 that did not undergo reconstruction ( p = 0.0192), but this difference was no longer present in women over 60 years), 35 and younger age was found to be significantly associated with a desire for further plastic surgery to improve cosmetic results after breast-conserving surgery ( p < 0.001). 33 Adjuvant radiation was found to increase body image concerns 54 and distress in younger women ( p =0.01), 2 and chemotherapy treatment was also found to have a negative impact on body image among younger women ( p <0.05).…”

Qualidade de vida e a cirurgia em cancro da mama: revisão narrativa da literatura

“…Estima-se que um terço das mulheres com cancro da mama sejam submetidas à mastectomia (Boukerrou, Saal, Laurent, Barau, & Clough et al, 2010;Lardi et al, 2013).…”