Psychological impact and cosmetic outcome of surgical breast cancer strategies

Nano, Maria Teresa; Gill, P. Grantley; Kollias, James; Bochner, Melissa; Malycha, Peter; Winefield, Helen R.

doi:10.1111/j.1445-2197.2005.03517.x

Cited by 166 publications

(91 citation statements)

References 45 publications

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“…There was no difference between the two groups with regard to scores for overall health, physical, psychological and social function, and for symptoms. This result is in keeping with those from other studies (15;16), notably the study conducted by Nano et al (17), which showed the absence of any difference in quality of life but better body image in patients undergoing conservative treatments and reconstructions compared to that in patients who had mastectomy without reconstruction. The fact that the effect of reconstruction is restricted to improved body image has many factors.…”

Section: Evaluation Of Body Image and Of Quality Of Lifesupporting

confidence: 82%

Evaluation of quality of life after breast reconstruction using an autologous latissimus dorsi myocutaneous flap

Gournay

Bonnetain

Tixier

et al. 2010

European Journal of Surgical Oncology (EJSO)

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Aims: To evaluate the patients' satisfaction with breast reconstruction using the autologous latissimus dorsi technique and the impact of the procedure on the quality of life and body image of women who had mastectomy for breast cancer. were sent through the post following surgery. Methods Results:The overall response rate was 77% and the mean (MBROS-S) satisfaction score was 3.36. The quality of life (EORTC QLQ-C30, EORTC QLQ-BR23) in RW was no better than that in NRW, but body image was better (p=0.0247) especially before 60 years (p= 0.0192), in obese patients (p=0.03) and when the breasts of RW were heavy (p=0.0197). Moreover, when the time from the mastectomy was less than 4 years, body image (p=0.0008) and the sexual activity score (p= 0.0078) were higher in RW. Conclusions:The level of satisfaction was higher in RW, and breast reconstruction made a strong contribution in terms of improvement in body image. A prospective study to evaluate quality of life in the long term is now necessary. words

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Section: Evaluation Of Body Image and Of Quality Of Lifesupporting

confidence: 82%

Evaluation of quality of life after breast reconstruction using an autologous latissimus dorsi myocutaneous flap

Gournay

Bonnetain

Tixier

et al. 2010

European Journal of Surgical Oncology (EJSO)

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“…Previous studies have investigated the influence of cosmetic outcome on psychosocial morbidity in primary breast cancer [6,20]. These studies reported a good correlation between satisfaction with cosmetic outcomes and positive body image perception, sexuality and self-esteem and showed that the more conservative was breast surgery the better were quality of life and psychological adjustment.…”

Section: Discussionmentioning

confidence: 82%

Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality?

Didier

Radice

Gandini

et al. 2008

Breast Cancer Res Treat

256

128

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We investigated the influence of nipple areolar complex (NAC) sparing in mastectomy, on patient satisfaction with cosmetic results, body-image, sexuality and psychological well-being. We developed a specific questionnaire and compared two groups of women who underwent radical mastectomy with immediate breast reconstruction (IBR). Between 2004 and 2006, 310 women with NAC preservation and 143 patients with successive NAC reconstruction were mailed the questionnaire at follow-up 1 year after definitive complete breast reconstruction surgery. 256 questionnaires was available. Our results showed significant differences in favour of the NAC sparing group regarding body image (difficulty in looking at themselves naked and being seen naked by their partners after surgery, P = 0.001 and P = 0.003, respectively); regarding satisfaction with the appearance of the nipple (P \ .0001) and with the sensitivity of the nipple (P = 0.001); regarding the feeling of mutilation (P = 0.003). NAC sparing in mastectomy has a positive impact on patient satisfaction, body image and psychological adjustment.

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“…Skin sparing mastectomies (SSMs) and immediate breast reconstruction (IBR) preserves the natural contours by sparing the native skin, preserves sensation, minimises scars, gives cosmetic results (thereby increasing self esteem) and lowers psychological morbidity. 1 Oncological safety in terms of local and systemic recurrence is a serious concern.…”

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confidence: 99%

A single institution experience with skin sparing mastectomy and immediate breast reconstruction

Doddi

Singhal

Kasem

et al. 2011

annals

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According to the NHS Information Centre's Hospital Episode Statistics, 131,566 women in England were diagnosed with breast cancer in [2004][2005]. Of these, 16,838 underwent a mastectomy, of which only 1,623 (9.6%) benefited from a skin sparing approach. It is expected that almost all women who have been recommended a mastectomy will be offered reconstruction in the immediate setting or as a delayed procedure. Skin sparing mastectomies (SSMs) and immediate breast reconstruction (IBR) preserves the natural contours by sparing the native skin, preserves sensation, minimises scars, gives cosmetic results (thereby increasing self esteem) and lowers psychological morbidity.1 Oncological safety in terms of local and systemic recurrence is a serious concern. MethodsA retrospective study was carried out on all patients with breast cancer treated with an SSM and IBR over a six-year period from 1999 to 2005. A single consultant breast surgeon carried out all SSMs and IBRs in a single institution. All patients were discussed in our local multidisciplinary meeting before and after surgery. ResultsA total of 108 patients, with a mean age of 49 years (range: 28-70 years), underwent an SSM and IBR, of which 78 patients (72.22%) had invasive cancer and 30 (27.78%) had a ductal carcinoma in situ (DCIS) only. Of the invasive cancers, 63 were ductal, 9 were lobular and 6 had other histological types. The mean tumour size of the invasive cancers on final histology was 29.9mm and ranged from 2mm to 100mm. Tumour grade (modified Scarff-Bloom-Richardson grading system), 2,3 lymph node involvement, lymphovascular invasion and receptor status are given in Table 1, Nottingham prognostic index in Table 2 and TNM (tumour, nodes, metastasis) staging 4 in Table 3. In our series of 108 patients, 67 patients had a primary mastectomy, 27 had a completion mastectomy and 8 patients underwent an SSM for recurrence after breast conserving surgery. Four patients had a bilateral SSM for bilateral disease. Three patients opted for a contralateral prophylactic mastectomy.Seventy-five patients (69.44%) had a latissimus dorsi flap with or without an implant and five patients (4.62%) underwent reconstruction utilising a pedicled transverse rectus abdominis myocutaneous flap. The other 28 patients (25.93%) had implant-based reconstruction only.Of the 25 patients who had post-reconstruction radiotherapy, 9 developed a capsular contracture and 8 of these required an exchange of implant. Thirty-three patients (30.56%) had chemotherapy, of whom 20 required adjuvant radiotherapy as well. Two patients in our series had neoadjuvant chemotherapy prior to their SSM and IBR. In two patients there was a delay of two months in commencement

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Psychological impact and cosmetic outcome of surgical breast cancer strategies

Cited by 166 publications

References 45 publications

Evaluation of quality of life after breast reconstruction using an autologous latissimus dorsi myocutaneous flap

Evaluation of quality of life after breast reconstruction using an autologous latissimus dorsi myocutaneous flap

Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality?

A single institution experience with skin sparing mastectomy and immediate breast reconstruction

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