Met and Unmet Expectations for Breast Reconstruction in Early Posttreatment Breast Cancer Survivors

Steffen, Laurie E.; Johnson, Aimee K.; Levine, Beverly; Mayer, Deborah K.; Avis, Nancy E.

doi:10.1097/psn.0000000000000205

Cited by 24 publications

(15 citation statements)

References 43 publications

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“…This is a common practice among women in Sub-Saharan Africa where breast reconstruction surgeries are limited, and also, breast prostheses are difficult to procure and afford by people. However, in the advanced countries, even though women who undergo a mastectomy have access to silicone breast implants and other breast reconstruction techniques, these women equally encounter pain and poor appearance of their reconstructed breast with some opting to maintain a 'flat chest' to avoid multiple surgeries and risks of silicon related dangers [39,40]. There is a need for health care providers to procure image enhancement equipment like silicone implants to give hope to those undergoing surgery.…”

Section: Discussionmentioning

confidence: 99%

Psychological and physical effects of breast cancer diagnosis and treatment on young Ghanaian women: a qualitative study

2020

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Background Young women diagnosed with breast cancer face challenges that interfere with their entire life with psychological and physical effects. Method We employed a qualitative exploratory descriptive design, and recruited twelve participants through purposive and snowball sampling methods to conduct 12 face to face individual interviews. A reputable review board in Ghana; Noguchi Memorial Institute for Medical Research, gave ethical clearance for data collection. Data were transcribed verbatim and analysed using thematic content analysis. Results Three themes emerged from the data; physical effects of breast cancer, effects of treatment on body image, and emotional effects of breast cancer diagnosis and treatment. The negative effects of treatment incapacitated most of the women and limited their activities of daily living. Some experienced severe bodily weakness and stayed indoors for days. Most participants felt they looked unattractive because they have had a mastectomy done, and used pieces of rags and handkerchiefs as breast prostheses. Those who had hair loss through chemotherapy used different kinds of wigs to cover their baldness. Almost all the participants cried, felt depressed, and became emotionally unstable when they were told their diagnosis. Some denied their diagnoses and displaced their anger on healthcare personnel. A few of them felt they had brought disgrace to their families because breast cancer is perceived, a disgraceful disease. Conclusion Young women diagnosed with breast cancer require psychological interventions and physical support from healthcare personnel and their families.

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Section: Discussionmentioning

confidence: 99%

Psychological and physical effects of breast cancer diagnosis and treatment on young Ghanaian women: a qualitative study

2020

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“…In this report, participants mentioned feelings of increased preparedness and confidence before surgery after viewing 3D images. This is important, because over 40% of women undergoing mastectomy and reconstruction perceived their outcome to be worse than expected—particularly with regards to aesthetics [ 11 ]. Surgical teams already derive added value from utilising 3D images for aesthetic assessment after breast surgery [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Improving preparedness prior to reconstructive breast surgery via inclusion of 3D images during pre-operative counselling: a qualitative analysis

et al. 2021

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Background A proportion of women undergoing mastectomy for breast cancer choose to undergo breast reconstruction. Evidence suggests that women’s preparedness for this surgery is low and that this may contribute to feelings of unmatched expectations and anxiety. There is substantial interest in decision-aids to remedy this. This study explores the incorporation of digitally rendered three-dimensional images into pre-operative counselling sessions as a means of enhancing patient preparedness. Methods A database of three-dimensional images was produced showing both optimal and sub-optimal aesthetic outcome, matched to participant on the basis of type of surgical reconstruction, body habitus, and skin tone. Women undergoing mastectomy for breast cancer followed by immediate reconstruction were targeted for inclusion. Participants interacted with image software during pre-operative counselling sessions by viewing, rotating, and zooming in/out to gain a more in-depth appreciation of post-operative aesthetic outcome. Semi-structured face-to-face interviews followed thereafter. Interviews were audio-recorded, transcribed, coded, and themes identified. Results Eight semi-structured interviews took place. The major emergent theme was ‘increased preparedness’ with subthemes including ‘expectation management’, ‘software interaction’, and ‘enhanced realism’. There were no prohibitively negative emotions after interacting with images. Women reported gaining ‘more of a perspective’ and feeling ‘more informed’ after viewing images. They also valued the enhanced interactivity and better appreciation of reconstructed breast symmetry that viewing three-dimensional images offered when compared to viewing two-dimensional photographs. Finally, women also commented that three-dimensional images were more realistic. Conclusions Results suggest that incorporation of three-dimensional images into pre-operative counselling sessions prior to breast reconstruction, is a fairly simple yet effective method of enhancing patient preparedness prior to surgery. Women particularly valued the ability to use the software to generate a more realistic idea of what to expect after their operation. Future work should focus on better understanding any quantifiable benefit from incorporating three-dimensional images routinely into pre-operative decision-making.

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“…(2) Some women who undergo unilateral mastectomy do not anticipate that additional procedures on the contralateral breast are typically required to mitigate asymmetry between the breast mounds. 14 , 18 , 20 , 25 , 26 Therefore, we reviewed each photograph set to assess whether symmetry procedures had been performed and whether this information was clearly disclosed. (3) Patients who choose an autologous reconstruction can have many misconceptions about the postoperative shape, size, and maturation of donor site scarring.…”

Section: Methodsmentioning

confidence: 99%

What Does “Dr. Google” Show Patients Searching for Breast Reconstruction Outcomes Photographs?

Nicklaus

Gonzalez

Sachdev

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Many women with breast cancer search the internet for photographs of their potential reconstruction outcomes, but little is known about the quality, variety, and relevance of images patients are viewing. Methods: Breast reconstruction outcome photographs identified by a Google Images search were assessed based on the American Society of Plastic Surgeons/Plastic Surgery Foundation photographic guidelines. Information such as source metadata, breast reconstruction procedure information, and subject demographics was collected from the photographs. Additional analyses were conducted to assess whether nipple reconstruction or tattooing occurred and was disclosed, whether a symmetry procedure was performed and disclosed, and whether donor site scarring is visible in abdominal flap photographs. Results: We acquired and analyzed 114 photograph sets. Although a variety of images were readily available, the majority of photograph sets did not follow photographic guidelines or provide sufficient information. Most photograph sets (60%) indicated symmetry procedures when a symmetry procedure was evident, but only 40% of photograph sets disclosed a nipple procedure when a nipple procedure was evident. Only 40% of abdominal flap photographs showed donor site scarring. Subject demographics were largely missing: 50% of photograph sets included subject age, 3% included race or ethnicity, and 12% included weight or BMI. Conclusions: Although breast reconstruction outcome photographs shown by “Dr. Google” represent a variety of reconstruction types, they typically lack information that a patient needs to assess self-applicability. Patients may benefit from discussion with their healthcare team about the strengths and limitations of breast reconstruction outcome photographs available on the internet.

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Met and Unmet Expectations for Breast Reconstruction in Early Posttreatment Breast Cancer Survivors

Cited by 24 publications

References 43 publications

Psychological and physical effects of breast cancer diagnosis and treatment on young Ghanaian women: a qualitative study

Psychological and physical effects of breast cancer diagnosis and treatment on young Ghanaian women: a qualitative study

Improving preparedness prior to reconstructive breast surgery via inclusion of 3D images during pre-operative counselling: a qualitative analysis

What Does “Dr. Google” Show Patients Searching for Breast Reconstruction Outcomes Photographs?

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