The Psychological Effect of Mastectomy with or without Breast Reconstruction: A Prospective, Multicenter Study

Abstract

A multicenter, prospective study ( = 103) examined the psychological implications of women's decisions for or against breast reconstruction. Recognized measures of anxiety, depression, body image, and quality of life were completed before the operation, and 6 and 12 months later. A reduction in psychological distress over the year following the operation was evident in each surgical group (mastectomy alone or immediate or delayed reconstruction), indicating that reconstructive surgery can offer psychological benefits to some women; however, others report improved psychological functioning without this surgical procedure. In contrast to existing retrospective research, the prospective design enabled the process of adjustment during the first year after the operation to be examined. The results indicate that breast reconstruction is not a universal panacea for the emotional and psychological consequences of mastectomy. Women still reported feeling conscious of altered body image 1 year postoperatively, regardless of whether or not they had elected breast reconstruction. Health professionals should be careful of assuming that breast reconstruction necessarily confers psychological benefits compared with mastectomy alone.

Immediate post-mastectomy breast reconstruction followed by radiotherapy: risk factors for complications

“…The association with HT appears to be statistically significant, without any clear explanations. Nevertheless, CC remains difficult to assess, as illustrated by the high variance of data found in literature (17-68%) [12,18,[24][25][26]. This may be explained by differences in patient follow-up: rate of CCs increases with increasing duration of follow-up [30].…”

“…IPMR using the TE/I technique after breast cancer offers cosmetic and psychological advantages [12] for both the patient and the surgeon, with only a few contraindications. Our study involved a sizeable and homogenous population of patients who underwent IPMR using the TE/I technique followed by RT.…”

“…Many patients select post-mastectomy reconstruction because it reduces the psychological and cosmetic impact of the mastectomy [12]. Furthermore, the cost of immediate reconstruction is lower than that of delayed reconstruction [14].…”

Angelina Jolie’s faulty gene: newspaper coverage of a celebrity’s preventive bilateral mastectomy in Canada, the United States, and the United Kingdom

“…Only 19 articles (18.4%) mentioned the possible drawbacks of preventive mastectomy, e.g., the incidence of breast reconstruction prosthesis infection 34 or the emotional or psychological consequences that mastectomies have on women, even in cases when the operation is immediately followed by breast reconstruction. 35,36 When crosstabulated by country, the results showed discussions of these topics in six articles published in Canada, six articles in the United States, and seven in the United Kingdom. Nonetheless, 33 articles (32%) did mention the benefits of evidence-based decisions regarding BRCA1/2 testing and genetic risk assessment.…”

Personality traits and psychosocial stress: quality of life over 2 years following breast cancer diagnosis and psychological impact factors

“…In addition, the baseline assessment in this sample appears to indicate only moderate impairment of cognitive functioning. Finally, the lack of change with regard to body image needs to be considered in comparison with studies that have demonstrated an improvement in body image over time, especially in women who have undergone mastectomy [41]-probably due to increasing skills in coping with body image impairment. The controversial finding of a lack of change in body image might be explained by the high percentage of women in the present study who were treated with BCT (92%); the scores for body image in the sample were consequently fairly high over all measurement time-points and are thus not comparable with data from studies in which the majority of patients were treated with mastectomy [20].…”