Psychological Reactions, Quality of Life, and Body Image After Bilateral Prophylactic Mastectomy in Women At High Risk for Breast Cancer: A Prospective 1-Year Follow-Up Study

Brandberg, Yvonne; Sandelin, Kerstin; Erikson, Staffan; Jurell, Göran; Liljegren, Annelie; Lindblom, Annika; Lindén, Ann; Wachenfeldt, Anna von; Wickman, Marie; Arver, Brita

doi:10.1200/jco.2007.13.9568

Cited by 224 publications

(174 citation statements)

References 25 publications

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“…While earlier studies suggest that sexual functioning is not compromised by RRM, there is evidence that about half of the women who undergo this procedure report some issues with body image and sexuality [15,19,21], like the women in this study. Our study suggests that while many of our interviewees had some expectations of how their breasts might look post-surgery, few had any realistic expectations about the changes in sensation in their breasts, changes which were uniformly experienced as disturbing.…”

Section: Discussioncontrasting

confidence: 64%

“…This study suggests that while many women correctly anticipate many of the visible sequelae of risk-reducing surgery, it is also apparent that many remain unprepared for the changes in the way their bodies feel [21,24,26,36] and the ways they may feel about themselves [15,21,25,27,38] following surgery. While health care professionals may do their best to prepare women for physical changes, pain, scarring and reduced libido, there is evidence that the impact upon sexuality, body image and gender identity are not routinely discussed by surgeons and, in line with recommendations made in recent papers [28], we argue that these issues are important topics for discussion in preoperative consultations.…”

Section: Discussionmentioning

confidence: 84%

“…A number of studies that have investigated the psychosocial sequelae of RR surgery suggest these procedures are associated with a decrease in cancer anxiety [15][16][17]. However, while many women who have RRM plus breast reconstruction are pleased with the appearance of their new breasts [18][19][20], some experience ongoing complications following reconstructive surgery [21,22]; are unhappy with the cosmetic result, particularly the lack of sensation in their breasts [22][23][24]; and report a negative impact upon sexual functioning [15,22,25,26].…”

Section: Introductionmentioning

confidence: 99%

“…However, while many women who have RRM plus breast reconstruction are pleased with the appearance of their new breasts [18][19][20], some experience ongoing complications following reconstructive surgery [21,22]; are unhappy with the cosmetic result, particularly the lack of sensation in their breasts [22][23][24]; and report a negative impact upon sexual functioning [15,22,25,26]. Similar findings have been reported in studies of RRSO, which indicate that some symptoms of surgically induced menopause, primarily hot flushes and loss of libido, are experienced negatively by women who undergo RRSO [27].…”

Section: Introductionmentioning

confidence: 99%

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Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

et al. 2011

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Objectives Most studies of quality of life following risk-reducing bilateral salpingo -oophorectomy (RRSO) and mastectomy (RRM) for inherited breast and ovarian cancer susceptibility were conducted before counseling protocols were established and included women at varying times since surgery. This study aimed to overcome these deficiencies and to provide current data on outcomes for this growing group of women.Methods Semi-structured interviews were used to explore the experiences of an Australian cohort of 40 high-risk women three years after they underwent RRM and/or RRSO. Data were analyzed using the method of constant comparison.Results Nineteen women underwent RRSO, 8 RRM and 13 both procedures. Two themes -looking different and feeling different -captured the psychosocial impact of surgery upon interviewees. All were relieved at having the risk of cancer substantially reduced that had previously been embodied in their breasts and ovaries; however, reducing risk by removing these body parts is not without costs. Interviewees reported experiencing a range of negative emotions and a range of unexpected bodily sensations following surgery and reflected upon both positive and negative changes in their appearance. Women said they had been unprepared for the lack of sensation in reconstructed breasts and/or the severity of menopausal symptoms, which often had a negative impact upon sexuality. ConclusionsAlthough women who undergo RR surgery are informed about its sequelae, however, few are entirely prepared for the reality of undergoing this procedure. We recommend that women who undergo these procedures should be provided with psychosocial support before and after RR surgery.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

et al. 2011

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“…It was used initially in patients who had been in clinical psychiatric hospitals, and then extended to evaluate a non-hospitalized patient with some type of disease or individuals without disease [17][18][19][20] . HADS does not consider vegetative symptoms associated with depression and anxiety [21][22] , and it also does not allow interferences of somatic symptoms in the assessment.…”

Section: Design and Samplementioning

confidence: 99%

Depression Subscale of the Hospital Anxiety and Depression Scale applied preoperatively in spinal surgery

Falavigna

Righesso²,

Teles

et al. 2012

Arq. Neuro-Psiquiatr.

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Depression and anxiety are mood disorders that are commonly related to chronic illnesses. The overall frequency in hospitalized patients has an index of variation between 20 and 60% 1-3 , and they are not recognized in one third of patients 4 . Their frequency can be higher in patients without mood disorders presenting symptoms caused by physical illness or preoperative anxiety, which range from 11 to 80% in adults 5 . This variation is related to the sociodemographic characteristics of the population studied, type of disease, degree of involvement, chronicity, and variability of the methodological definitions used in the studies, such as the cutoff point, the search tools, and the case definition. The literature offers different scales for the assessment of anxiety and depression, such as Beck Depression Inventory (BDI), Hospital Palavras-Chave: cirurgia da coluna, depressão,

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Management of Women With BRCA Mutations

Tung¹

2011

JAMA

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Ms E, a 41-year-old BRCA1 mutation carrier, was diagnosed 4 years ago as having breast cancer and opted for breast-conserving therapy. Prior to receiving chemotherapy, she harvested her eggs through in vitro fertilization and subsequently used preimplantation genetic diagnosis; 3 months ago she delivered a healthy boy. This review examines the prevalence of BRCA mutations in women with breast cancer, as well as current recommendations for surgery and systemic therapy in these women. In particular, the risk of a contralateral breast cancer is reviewed to help guide the choice of prophylactic mastectomies vs breast-conserving therapy. The technology of preimplantation genetic diagnosis and genetic testing in relatives of mutation carriers is discussed.

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Psychological Reactions, Quality of Life, and Body Image After Bilateral Prophylactic Mastectomy in Women At High Risk for Breast Cancer: A Prospective 1-Year Follow-Up Study

Abstract: No negative effects on anxiety, depression, and quality of life were found. Anxiety and social activities improved. Negative impact on sexuality and body image was reported.

Cited by 224 publications

References 25 publications

Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

Depression Subscale of the Hospital Anxiety and Depression Scale applied preoperatively in spinal surgery

Management of Women With BRCA Mutations

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