The present state and perception of young women with breast cancer towards breast reconstructive surgery

Nozawa, Keiko; Ichimura, Miho; Oshima, Akira; Tokunaga, Eriko; Masuda, Norikazu; Kitano, Atsuko; Fukuuchi, Atsushi; Ono, Shinji

doi:10.1007/s10147-014-0716-0

Cited by 11 publications

(9 citation statements)

References 10 publications

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“…Similar to previous studies , , the main reasons for patients in the present study to decline immediate breast reconstruction were the patient's perception of her age and concerns about two sites of surgery. Concern over the financial costs of treatment is more apparent in Asian studies, and was evident in the present study. In Singapore, healthcare payment is a co‐payment system whereby healthcare‐related costs are subsidized partially by the government and the rest is borne by the consumer (patient).…”

Section: Discussionsupporting

confidence: 80%

Factors influencing patient decision-making between simple mastectomy and surgical alternatives

et al. 2018

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BackgroundDespite similar survival rates, breast‐conserving therapy (BCT) remains a distant second choice after simple mastectomy for patients with early‐stage breast cancer in Singapore. Uptake of reconstruction after mastectomy is also low (18 per cent). The aim of this study was to explore the factors influencing a patient's choice for mastectomy when eligible for BCT, and why patients decline reconstruction after mastectomy.MethodsPatients from the National Cancer Centre Singapore, who were eligible for BCT but chose mastectomy without reconstruction, between December 2014 and December 2015 were included. An interviewer‐administered questionnaire focusing on patients' reasons for choosing mastectomy over BCT and not opting for immediate breast reconstruction after mastectomy was used. Tumour characteristics were retrieved from medical records. Spearman's rank correlation coefficient, Mann–Whitney U and Kruskal–Wallis tests were used to analyse the correlation between the patient's self‐rated influential factors and variables. Statistical significance was taken as P < 0·050.ResultsNinety‐one patients were included (90·1 per cent response rate). The main reasons for choosing mastectomy over BCT were: fear of cancer recurrence (considered very important in 74 per cent), the perception that health outweighs breast retention (49 per cent) and the possibility of second surgery for margins (40 per cent). Key factors for rejecting immediate reconstruction after mastectomy were: patient‐perceived ‘old age’ (very important in 53 per cent), concern about two sites of surgery (42 per cent) and financial cost (29 per cent). Given a second chance, 19·8 per cent of patients would undergo BCT instead of mastectomy.ConclusionThis study has identified the considerations that women in Singapore have when deciding on breast cancer surgery. Some perceptions need to be addressed for women to make a fully informed decision, especially as one‐fifth regret their initial choice.

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Section: Discussionsupporting

confidence: 80%

Factors influencing patient decision-making between simple mastectomy and surgical alternatives

et al. 2018

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“…Among the 45 quantitative studies, 12,34,35,37–39,41–44,61–95 body image was an outcome in 32 studies (71.1%), a predictor in eight studies (17.8%), and was included only descriptively in three studies (6.8%). The remaining two studies (6.7%) did not identify the type of variable body image was.…”

Section: Resultsmentioning

confidence: 99%

“…An overview of relationships is presented in Table 1. Among the studies that reported effect sizes ( n = 14), adjusted odds ratios ranged from 0.47–15.53 68 , 74 , 82 , 86 , 92 and correlation coefficients ranged from 0.20–0.82 65 , 75 , 77 , 79 , 85 for the associations with negative body image and correlation coefficients ranged from 0.26–0.95 for the associations with positive body image 61,62,81,104 . Twenty‐seven (60%) articles examined group differences in body image (see Table 2).…”

Section: Resultsmentioning

confidence: 99%

Body image among adolescents and young adults diagnosed with cancer: A scoping review

et al. 2021

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Objective Cancer and treatment can produce temporary or permanent body changes, which may affect the body image (BI) of adolescents and young adults diagnosed with cancer (AYAs). This evidence has not been comprehensively summarized. A scoping review was conducted to explore the available evidence on BI among AYAs and identify the definitions, theories, models, frameworks, measures, and methods used to assess BI. Methods Databases MEDLINE, EMBASE, PsycINFO (via Ovid) and CINAHL and Gender Studies (via EBSCO) were searched to identify published studies from 1 January 2000 to 25 November 2019. Inclusion criteria were: qualitative, quantitative, or mixed methodology; at least one BI‐related measure or theme; published in English; and majority of the sample between 13 and 39 years at diagnosis and a mean age at diagnosis between 13 and 39 years. Two authors screened the titles, abstracts, and full‐text articles and data were extracted and summarized. Results The search yielded 11,347 articles and 82 met inclusion criteria. Articles included 45 quantitative, 33 qualitative, and four mixed‐methods studies. The majority of studies used cross‐sectional designs, while BI definitions, theories, models, frameworks, and measures were varied. Studies explored descriptive, psychological, physical, coping, and social factors, with BI being described most often as an outcome rather than a predictor. Conclusions Theory‐based research that employs a holistic BI definition and uses longitudinal or intervention study designs or a qualitative methodology is needed to better understand the BI experience of AYAs and inform the development of strategies and programs to reduce BI concerns and increase positive body experiences.

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“…21 In another survey study of Japanese women aged 45 years and younger, breast reconstruction rate was 36.7%. 22 The most common reason for not undergoing breast reconstruction was the fear of cancer relapse. Other factors mentioned were to avoid additional distress on the body from surgery, financial reasons, and belief that breast reconstruction is unnecessary.…”

Section: Discussionmentioning

confidence: 99%

Equivalent Survival With Mastectomy or Breast-conserving Surgery Plus Radiation in Young Women Aged < 40 Years With Early-Stage Breast Cancer: A National Registry-based Stage-by-Stage Comparison

Yan

Christos

et al. 2015

Clinical Breast Cancer

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Introduction/Background Studies have shown that young patients with early-stage breast cancer (BC) are increasingly getting mastectomy instead of breast conserving therapy (BCT) consisting of lumpectomy and radiation. We examined the difference between outcomes in young women (age<40) treated with BCT versus mastectomy. Materials and Methods The Surveillance, Epidemiology, and End Results database was queried for women <40 years of age with stage I–II invasive BC treated with surgery from 1998–2003. Breast cancer specific survival (BCSS) and overall survival (OS) were evaluated by Kaplan-Meier survival analysis and the log–rank test between treatment types. Results Of the 7665 women, 3249 patients received BCT, while 2627 patients had mastectomy and no radiation. When separated by stage (I, IIA, and IIB), with median follow-up of 111 months, the BCT and mastectomy only groups showed no statistically significant differences in the BCSS and OS. Overall, age group 35–39 (66% of total) was associated with better 10-year BCSS (88%) and OS (86.1%) compared to younger patients aged 20–34 (34% of total), who had 10-year BCSS and OS of 84.1% and 82.3%, respectively (P<0.001 for both BCSS and OS). However, when patients of each age group were further subdivided by stages, the BCT group continued to show non-inferior BCSS and OS compared to the mastectomy group in all of the subgroups. Conclusion Our study suggests that while young age may be a poor prognostic factor for BC, there is no evidence that these patients have better outcome with mastectomy over BCT.

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The present state and perception of young women with breast cancer towards breast reconstructive surgery

Abstract: Regardless of deciding to undergo breast reconstruction or not, the results of this study suggested the need for cognitive interventions to avoid patients fixating on self-consciousness over treated areas.

Cited by 11 publications

References 10 publications

Factors influencing patient decision-making between simple mastectomy and surgical alternatives

Factors influencing patient decision-making between simple mastectomy and surgical alternatives

Body image among adolescents and young adults diagnosed with cancer: A scoping review

Equivalent Survival With Mastectomy or Breast-conserving Surgery Plus Radiation in Young Women Aged < 40 Years With Early-Stage Breast Cancer: A National Registry-based Stage-by-Stage Comparison

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