Emotional expectations reported by hospitalized women in southeastern Brazil before being submitted to mastectomy with immediate breast reconstruction: A clinical-qualitative study

IntroductionBreast cancer is a type that more affects female population in the world. Surgical indication, present in most cases, is a mutilating procedure and mentally traumatic for majority of women subjected. Thus, immediate breast reconstruction, which is the choice to rebuild the breast during the mastectomy surgery, is an alternative to reduce discomforts associated with loss of the breast, in addition to being associated potentially with improved emotional and psychosocial quality of life.ObjectiveTo discuss, from psychological viewpoint, the emotional expectations about surgical results of a planned mastectomy with immediate breast reconstruction, reported by women with breast cancer treated in a university hospital in Campinas, state of São Paulo.MethodQualitative design, particularized in the clinical-qualitative method, adequate to health assistant settings, using the semi-directed interview with open-ended questions in-depth, fully transcribed and after submitted to content clinical-qualitative analysis. Intentional sample closed by criterion of information theoretical saturation with 12 sequential participants.ResultsAmongst the emergent categories from free-floating readings, we have chosen the following to presentation:.–The desire of healing above expectations of the aesthetic aspects;–The perception of the surgical approach predominantly with aesthetic effects;–The desire of a contra-lateral healthy breast withdrawal, too.ConclusionsFace the proposal of mastectomy with immediate reconstruction, days before the surgery, women reported to be well emotionally organized for the procedure, although in different ways. This occurs probably due to emotional meanings built by many experiences from their psychological histories, as well as from values provided by the socio-cultural environments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Recurrences after Immediate Reconstruction in Breast Cancer

Scandinavian Journal of Surgery ◽

10.1177/145749690509400106 ◽

2005 ◽

Vol 94 (1) ◽

pp. 21-24 ◽

Cited By ~ 1

Author(s):

P. Mustonen ◽

V. Kataja ◽

M. Berg ◽

T. Pietiläinen ◽

A. Papp

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Cancer Patients ◽

Immediate Breast Reconstruction ◽

University Hospital ◽

Safe Procedure ◽

Primary Therapy ◽

Breast Cancer Patients ◽

Immediate Reconstruction ◽

Visceral Metastases

Aim: To determine the incidence of and reasons for recurrences after immediate breast reconstruction in breast cancer patients. Material and Methods: The data of 79 patients undergoing immediate breast reconstruction between 1998 and 2001 in Kuopio University Hospital were re-examined from both the local cancer register and the patient charts at the end of year 2003. Results: There were five local recurrences (6.3 %), one regional recurrence (1.2 %), and three cases (3.8 %) presented bone and/or visceral metastases. All recurrences except one (primary tumor noninvasive) appeared within the first two years after primary therapy. Young age and increasing size of the tumour were risk factors for distant or logoregional metastases. Conclusion: Immediate breast reconstruction is a safe procedure in breast cancer patients, but a multidisciplinary team is needed for careful patient selection.

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Does Immediate Tissue Expander Placement Increase Immediate Postoperative Complications in Patients with Breast Cancer?

The American Surgeon ◽

10.1177/000313481508100225 ◽

2015 ◽

Vol 81 (2) ◽

pp. 143-149

Author(s):

Hossein Masoomi ◽

Keyianoosh Z. Paydar ◽

Gregory R. D. Evans ◽

Emily Tan ◽

Karen T. Lane ◽

...

Keyword(s):

Breast Cancer ◽

United States ◽

Hospital Mortality ◽

Breast Reconstruction ◽

Complication Rate ◽

Tissue Expander ◽

The United States ◽

Immediate Breast Reconstruction ◽

Perioperative Outcomes ◽

Immediate Reconstruction

The objectives of this study were to evaluate 1) the rate of immediate breast reconstruction; 2) the frequency of immediate tissue expander placement; and 3) to compare perioperative outcomes in patients who underwent breast reconstruction after mastectomy for breast cancer with immediate tissue expander placement (TE) with those with no reconstruction (NR). Using the Nationwide Inpatient Sample database, we examined the clinical data of patients with breast cancer who underwent mastectomy with or without immediate TE from 2006 to 2010 in the United States. A total of 344,253 patients with breast cancer underwent mastectomy in this period in the United States. Of these patients, 31 per cent had immediate breast reconstruction. We only included patients with mastectomy and no reconstruction (NR: 237,825 patients) and patients who underwent only TE placement with no other reconstruction combination (TE: 61,178 patients) to this study. Patients in the TE group had a lower overall postoperative complication rate (2.6 vs 5.5%; P < 0.01) and lower in-hospital mortality rate (0.01 vs 0.09%; P < 0.01) compared with the NR group. Fifty-three per cent of patients in the NR group were discharged the day of surgery compared with 36 per cent of patients in the TE group. Using multivariate regression analyses and adjusting patient characteristics and comorbidities, patients in the TE group had a significantly lower overall complication rate (adjusted odds ratio [AOR], 0.6) and lower in-hospital mortality (AOR, 0.2) compared with the NR group. The rate of immediate reconstruction is 31 per cent. TE alone is the most common type of immediate reconstruction (57%). There is a lower complication rate for the patients who underwent immediate TE versus the no-reconstruction cohort.

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Skin Sparing Mastectomy with Preservation of Nipple Areola Complex and Immediate Breast Reconstruction in Patients with Breast Cancer: A Single Centre Prospective Study

Plastic Surgery International ◽

10.1155/2014/589068 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Debarati Chattopadhyay ◽

Souradip Gupta ◽

Prabir Kumar Jash ◽

Marang Buru Murmu ◽

Sandipan Gupta

Keyword(s):

Breast Cancer ◽

Patient Satisfaction ◽

Local Recurrence ◽

Breast Reconstruction ◽

Frozen Section ◽

Immediate Breast Reconstruction ◽

Breast Cancer Patients ◽

Nipple Areola Complex ◽

Areola Complex ◽

The Aesthetic

Background. Skin and nipple areola sparing mastectomy (NASM) has recently gained popularity as the management of breast cancer. This study aims to evaluate the aesthetic outcome, patient satisfaction, and oncological safety of NASM. Methods. The study prospectively analyzes the results of NASM and immediate breast reconstruction in 34 women with breast cancer. The criteria for inclusion were core biopsy-proven, peripherally located breast cancer of any tumor size and with any “N” status, with documented negative intraoperative frozen section biopsy of retroareolar tissue, and distance from the nipple to tumor margin >2 cm on mammography. Results. The median age of the patients was 45 years. The majority had either stage II or stage III breast cancer. The median mammographic distance of tumor from nipple areola complex (NAC) was 3.8 cm. The overall operative morbidity was minimal. The NAC could be preserved in all the patients. There was no local recurrence of tumor at median follow-up of 28.5 months. The aesthetic outcomes were satisfactory. Conclusion. NASM and immediate breast reconstruction can be successfully achieved with minimal morbidity and very low risk of local recurrence in appropriately selected breast cancer patients, with acceptable aesthetic results and good patient satisfaction.

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Technical Advances in Skin Sparing Mastectomy

International Journal of Surgical Oncology ◽

10.1155/2011/396901 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Grant W. Carlson

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Marked Improvement ◽

Immediate Breast Reconstruction ◽

Oncological Safety ◽

Careful Patient ◽

Wide Acceptance ◽

Aesthetic Results ◽

Technical Advances ◽

The Aesthetic

Skin sparing mastectomy has resulted in marked improvement in the aesthetic results of immediate breast reconstruction. Mature data has confirmed its oncological safety in the treatment of breast cancer. The procedure has gained wide acceptance and has undergone numerous technical advances since its introduction over twenty years ago. Careful patient selection and choice of skin incisions are necessary to avoid complications.

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Influencers of Immediate Post-Mastectomy Reconstruction: A National Cancer Database Analysis

Aesthetic Surgery Journal ◽

10.1093/asj/sjab415 ◽

2021 ◽

Author(s):

Dora Danko ◽

Yuan Liu ◽

Feifei Geng ◽

Theresa W Gillespie

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Breast Reconstruction ◽

Urban Areas ◽

Private Insurance ◽

Immediate Breast Reconstruction ◽

Third Party ◽

National Cancer Database ◽

Immediate Reconstruction ◽

The Impact

Abstract Background The literature examining decision-making related to treatment and reconstruction for women with breast cancer has established that patient, clinical, and facility factors all play a role. Objectives Using the National Cancer Database (NCDB), determine how patient, clinical, and facility factors influence: 1) the receipt of immediate breast reconstruction; and 2) the type of immediate breast reconstruction received (implant-based, autologous, or a combination). Methods A total of 638,772 female patients with TIS-T3, N0-N1, M0 breast cancers were identified in the NCDB from 2004-2017 who received immediate reconstruction following mastectomy. Univariate and multivariable logistic regression models were conducted to identify characteristics associated with immediate breast reconstruction and type of reconstruction. Results Immediate breast reconstruction was more frequently associated with patients of white race, younger age, with private insurance, with lesser comorbidities, who resided in zip-codes with higher median incomes or higher rate of high-school graduation, in urban areas, with Tis-T2 disease, or with <4 lymph node involvement (all odds ratios (OR) > 1.1). Negative predictors of immediate breast reconstruction were insurance status with Medicaid, Medicare, other government insurance, and none or unknown insurance (all ORs <0.79). Implant-based reconstruction was associated with non-black race, uninsured status, completion of higher education, undifferentiated disease, and stage T0 disease (all ORs >1.10). Conclusions These findings confirm some previous studies on what patient, clinical, and facility factors affect decision making, but also raise new questions that relate to the impact of third-party payor on receipt and type of reconstruction post-mastectomy for breast cancer.

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Protocol for a multicentre, prospective, cohort study to investigate patient satisfaction and quality of life after immediate breast reconstruction in Japan: the SAQLA study

BMJ Open ◽

10.1136/bmjopen-2020-042099 ◽

2021 ◽

Vol 11 (2) ◽

pp. e042099

Author(s):

Miho Saiga ◽

Yuko Hosoya ◽

Hiroki Utsunomiya ◽

Yukiko Kuramoto ◽

Satoko Watanabe ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Breast Reconstruction ◽

Medical Center ◽

Immediate Breast Reconstruction ◽

University Hospital ◽

Ethical Guidelines ◽

Unilateral Breast Cancer ◽

Patient Reported

IntroductionThe aim of breast reconstruction (BR) is to improve patients’ health-related quality of life (HRQOL). Therefore, measuring patient-reported outcomes (PROs) would clarify the value and impact of BR on a patient’s life and thus would provide evidence-based information to help decision-making. The Satisfaction and Quality of Life After Immediate Breast Reconstruction study aimed to investigate satisfaction and HRQOL in Japanese patients with breast cancer who undergo immediate breast reconstruction (IBR).Methods and analysisThis ongoing prospective, observational multicentre study will assess 406 patients who had unilateral breast cancer and underwent mastectomy and IBR, and were recruited from April 2018 to July 2019. All participants were recruited from seven hospitals: Okayama University Hospital, Iwate Medical University Hospital, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Showa University Hospital, University of Tsukuba Hospital, Osaka University Hospital and Yokohama City University Medical Center. The patients will be followed up for 36 months postoperatively. The primary endpoint of this study will be the time-dependent changes in BREAST-Q satisfaction with breast subscale scores for 12 months after reconstructive surgery, which will be collected via an electronic PRO system.Ethics and disseminationThis study will be performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan’s Ministry of Education, Science and Technology and the Ministry of Health, Labour and Welfare, the modified Act on the Protection of Personal Information and the Declaration of Helsinki. This study protocol was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, on 2 February 2018 (1801-039) and all other participating sites. The findings of this trial will be submitted to an international peer-reviewed journal.Trial registration numberUMIN000032177.

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

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x581385 ◽

2011 ◽

Vol 93 (5) ◽

pp. 382-384 ◽

Cited By ~ 3

Author(s):

S Doddi ◽

T Singhal ◽

A Kasem ◽

A Desai

Keyword(s):

Breast Cancer ◽

Retrospective Study ◽

Breast Reconstruction ◽

Immediate Breast Reconstruction ◽

Single Institution ◽

Immediate Reconstruction ◽

Good Cosmetic Outcome ◽

Skin Envelope ◽

Good Cosmetic

INTRODUCTION Skin sparing mastectomies (SSMs) represent a surgical approach that preserves the natural skin envelope of the breast and, when combined with immediate reconstruction, offers a good cosmetic outcome. The aim of this retrospective study was to compare the risk of local recurrence (LR) in this series with the known rate of recurrence following a conventional mastectomy. METHODS A total of 108 patients with breast cancer who underwent an SSM and immediate breast reconstruction over a 6-year period were reviewed. RESULTS A follow-up of more than eight years showed that three patients (2.78%) had developed LR. CONCLUSIONS The rate of LR is low with SSMs and is comparable to that seen with conventional mastectomies.

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Comparison between Immediate and Delayed Prosthetic Breast Reconstruction Following Mastectomy

QJM ◽

10.1093/qjmed/hcaa050.064 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

B A Wassef ◽

W H Hassan ◽

R M Ahmed ◽

E S Shebl

Keyword(s):

Quality Of Life ◽

Breast Reconstruction ◽

Tissue Expander ◽

Immediate Breast Reconstruction ◽

University Hospital ◽

University Hospitals ◽

Immediate Reconstruction ◽

Safe Alternative ◽

Group A

Abstract Purpose to compare the outcomes of Immediate versus Delayed prosthetic breast reconstruction. Together with highlighting the importance of immediate reconstruction when it is feasible. Materials and methods This was a prospective study that was held at ain shams university hospitals and Helwan university hospital. The study included 20 patients who were planned to undergo a mastectomy either unilateral or bilateral, patients were divided equally in to 2 groups, (Group A) had an immediate breast reconstruction using mammary implants, while (Group B) had a delayed breast reconstruction using tissue expander then replacing it after a few months with a mammary implant, and the post operative complications were compared against each other. Results Although the number of complications were more in (Group A), but statistically it was found that the rate of complications after immediate reconstruction was non significant from after delayed reconstruction. Conclusion both immediate and delayed mastectomy reconstruction provide substantial safety and quality of life benefits for women choosing these procedures. Furthermore, patients who postpone reconstruction after mastectomy due to personal preference or by medical necessity can be reassured that this approach is a safe alternative to immediate reconstruction and can provide equivalent quality of life and body image benefits.

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Outcomes of skin sparing mastectomy with immediate breast reconstruction with Latissimus dorsi (LD) flap in surgical treatment of breast cancer

QJM ◽

10.1093/qjmed/hcaa050.060 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

S M Othman ◽

A K Elfekky ◽

M E Elshinawi ◽

A G Othman

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Breast Reconstruction ◽

Latissimus Dorsi ◽

Breast Conservation ◽

Immediate Breast Reconstruction ◽

Breast Conservation Surgery ◽

Autologous Reconstruction ◽

Immediate Reconstruction ◽

Aesthetic Result

Abstract Introduction Breast cancer is a devastating disease affecting women of all ages worldwide with the age incidence in Egypt being one decade younger than the mean age incidence, the latissimus dorsi (LD) flap is an important volume-replacement option due to its stability and versatility as an autologous flap. LD flap could be used for total breast reconstruction after mastectomy in selective cases or to fill a large quadrantectomy defect. Aim The aim of this study is to estimate the oncologic and aesthetic outcomes and the procedure-related complications of latissimus dorsi (LD) flap with skin sparing mastectomy in management of breast cancer. Patients On 25 patients breast cancer underwent skin-sparing mastectomy with immediate reconstruction using LD flap, Methods All patients were subjected to : (Complete history taken, General examination, Local examination and routine investigations) Surgical procedures 25 patients with breast cancer underwent skin-sparing mastectomy with immediate reconstruction with LD flap. Results Mean age of included patients was 41.12 years with mean BMI 29.17 kg/m2, regarding tumor classification DCIS represented 8% LCIS represented 20% IDC represented 32% ILC represented 40% of all patients, Positive lymph node 1-3 in 40% of patients and more than 3 in 20% of patients and 40% of patients had negative lymph node,96% of patients had no recurrence on the other hand only 4% shows locoregoinal recurrence, Regarding postoperative immediate complications 72% of patients showed no complications. Discussion In the current study we aimed to estimate the oncologic and aesthetic outcomes and the procedure-related complications of latissimus dorsi (LD) flap with skin sparing mastectomy in management of breast cancer. Conclusion Skin sparing mastectomy with immediate breast reconstruction using latissimus dorsi muscular flap allows single-stage, totally autologous reconstruction with a satisfactory aesthetic result, low morbidity, and good quality of life. Recommendations Breast cancer patients are best managed by a multidisciplinary team, Breast conservation surgery does often leave a significant deformity which can best be corrected by an immediate LD flap reconstruction, this method is simple and effective, our concept should be further analyzed in larger comparative studies.

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