Women’s motives to opt for either implant or DIEP-flap breast reconstruction

Gopie, Jessica P.; Hilhorst, Medard; Kleijne, Annelies; Timman, Reinier; Menke-Pluymers, Marian B. E.; Hofer, Stefan O. P.; Mureau, Marc A.M.; Tibben, Aad

doi:10.1016/j.bjps.2011.03.030

Cited by 46 publications

(33 citation statements)

References 37 publications

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“…4,8 Larger breasts are generally ptotic with a significant skin envelope and may not be as suitable for prosthetic-only reconstruction. 9,10 There have been numerous studies looking at body mass index (BMI); these have shown obesity to directly influence the type of reconstruction and significantly affect the outcome and complication rates. 11 Although obese woman often have large breasts, the available literature on breast size as an independent variable is limited.…”

mentioning

confidence: 99%

The Effects of Breast Size in Unilateral Postmastectomy Breast Reconstruction

Duggal

Grudziak

Metcalfe

et al. 2013

Annals of Plastic Surgery

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mentioning

confidence: 99%

The Effects of Breast Size in Unilateral Postmastectomy Breast Reconstruction

Duggal

Grudziak

Metcalfe

et al. 2013

Annals of Plastic Surgery

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“…Qualitative studies have consistently reproduced feelings of a lack of completeness or femininity after mastectomy without reconstruction . Although estimates of the rate of breast reconstruction following mastectomy vary widely between populations, the American Society of Plastic Surgeons estimates that more than one hundred thousand breast reconstructions are performed each year .…”

Section: Introductionmentioning

confidence: 95%

Preoperative breast size affects reconstruction status following mastectomy

et al. 2017

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Much research has been devoted to why women choose not to be reconstructed following mastectomy. The effect of breast size has not been well explored. The authors aimed to assess the relationship between breast size and reconstructive choices. A single-center retrospective review of women undergoing mastectomy between 2011 and 2014 was performed. Demographics, surgical variables, and reconstruction decisions were analyzed using t tests, Mann-Whitney U tests, and chi-squared tests. Significant (P < .05) variables were included in a multivariable logistic regression model. About 610 patients were analyzed. The median mastectomy specimen weight was 572 g (62-5230 g), which did not correlate with BMI (P = .44). Women who underwent reconstruction had lighter mastectomy specimens, averaging 643 vs 848 g (P < .0001). A regression controlling for ethnicity, insurance status, number of comorbidities, age at mastectomy, cancer stage, BMI, specimen weight, and mastectomy laterality was constructed. Lower specimen weight (P = .005), lower cancer stage (P = .008), bilateral mastectomy (P = .042), and younger age at mastectomy (P < .0001) were significantly associated with reconstruction. Women with larger breasts were less likely to be reconstructed regardless of their BMI and comorbidities. Larger breasted women may be considered worse prosthetic reconstruction candidates due to increased complications and suboptimal aesthetic outcomes but may find the increased invasiveness and recovery of autologous reconstruction an unattractive alternative. Furthermore, it is possible that surgeons may be less supportive of breast reconstruction for larger breasted women if there are concerns about safety or the aesthetic quality of the result. In the future, qualitative research must be done to determine why more larger breasted women choose not to be reconstructed as well as develop better ways to increase their reconstructive options.

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“…Women also cited the possibility of regaining their femininity, sexuality and self-confidence with BR. 21,[25][26][27]30 Fourteen women talked about ... the feeling of emptiness associated with mastectomy [...]. 26 Most opted for reconstruction because they wanted symmetry, and wanted to feel complete, normal.…”

Section: Women's Decision On Performing Breast Reconstructionmentioning

confidence: 99%

“…As a negative point related to reconstruction with impants, women mentioned the discomfort of the expansion process, and many did not know how long and uncomfortable this process would be. 28,30,33 They preferred to have a lesser impact from the surgery and wanted to return to their former routine as quickly as possible. 30 The process of tissue expansion took a year [...] the pain was' unbelievable'.…”

Section: Reporting the Advantages And Aisadvantages Of Breast Reconstmentioning

confidence: 99%

Breast Reconstruction From the Perspective of Women Submitted to Mastectomy: A Meta-Etnography

Volkmer

Santos

Erdmann

et al. 2019

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Objective: to analyze qualitative studies published in the national and international scientific literature on breast reconstruction after mastectomy for breast cancer, from the perspective of women. Method: systematic literature review using meta-ethnography, where the synthesis of knowledge is based on the induction and interpretation of the data found. Searches in the electronic databases identified 65 studies. 27 studides meet the inclusion and exclusion criteria. 13 studies compressed the analytical corpus of the review, according to the Critical Appraisal Skills Programme checklist. The data were synthesized by means of the meta-ethnographic approach. Results: the analyzed studies showed similarities regarding the women´s decision to perform breast reconstruction, the difficulty of choosing the type of surgery and to deal with the experience of the reconstruction, and that the women had difficulties in establishing relationships with certain health professionals, especially with doctors. They refer to the ambivalence of feelings regarding the expectations and results of breast reconstruction and complex process of "carrying on". Conclusion: this review synthesizes the scientific knowledge regarding women's perspective regarding the breast reconstruction process and highlights that health professionals must understand the perceptions of women undergoing mastectomy and breast reconstruction in order to improve the care provided.

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Women’s motives to opt for either implant or DIEP-flap breast reconstruction

Cited by 46 publications

References 37 publications

The Effects of Breast Size in Unilateral Postmastectomy Breast Reconstruction

The Effects of Breast Size in Unilateral Postmastectomy Breast Reconstruction

Preoperative breast size affects reconstruction status following mastectomy

Breast Reconstruction From the Perspective of Women Submitted to Mastectomy: A Meta-Etnography

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