scholarly journals Psychosocial Aspects of Immediate versus Delayed Breast Reconstruction

Breast Care ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. 374-377 ◽  
Author(s):  
Anne-Sophie Heimes ◽  
Kathrin Stewen ◽  
Annette Hasenburg

Background: Only little is known about the psychosocial aspects of breast cancer patients after mastectomy with immediate versus delayed breast reconstruction. Methods: We systematically screened PubMed using the following key words: mastectomy, immediate vs. delayed reconstruction, psychosocial aspects and quality of life. To highlight different psychological outcomes, studies were categorized into those describing: anxiety, depression, body image and satisfaction with the surgical outcome. We also compared patients after mastectomy alone with those undergoing immediate or delayed reconstruction. Results: Methodologies and psychological outcomes varied among the identified studies, making it difficult to compare results. There are contradictory outcomes concerning the psychosocial aspects of breast cancer patients after mastectomy alone compared with those who underwent an immediate or delayed reconstruction following mastectomy. Some studies show that immediate reconstruction after mastectomy had a positive impact on patients' psychological well-being. In contrast, other studies indicated that in the long-term view the compared patient groups were very similar concerning psychosocial aspects. Conclusion: Analyzing different aspects of psychosocial well-being after breast cancer surgery, there might be an advantage in choosing immediate reconstruction, if oncological safety allows it.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12587-e12587
Author(s):  
Sidra Afzal ◽  
Asad Parvaiz ◽  
Nida Javed

e12587 Background: : Although post mastectomy Immediate breast reconstruction has shown to improve physical and psychosocial well-being of breast cancer patients, this is not a usual procedure in Pakistan due to limited resources and lack of awareness. The aim of our study is to evaluate patient’s satisfaction/ aesthetic outcomes between the patients undergoing mastectomy alone (Group A) and the ones undergoing mastectomy followed by immediate reconstruction (Group B). Methods: This is a prospective study conducted at Shaukat Khanum Hospital Pakistan comparing aesthetic outcome, patient’s satisfaction and Quality of life between two groups using Breast Q module. All patients undergoing mastectomy with and without reconstruction between April 2017 to July 2019 are included. Sample size of 84 was calculated (42 in each group). Results: The mean Q score of satisfaction with the breast in group B is 82.64 and in group A is 35.82 (P = 0.001). The mean Q score of Psychosocial well-being in group B is 89 vs 44.95 in group A (P = 0.001). The mean Q score of Physical well-being in group B is 98.23 vs 90.41 in group A (P = 0.002). The mean Q score of sexual well-being in group B is 81.93 vs 43 in Group A (P = 0.001). [Mean difference in score of 5-10 - little change, 10-20 - moderate change, > 20 - significant change].The mean difference between two groups in satisfaction with breast , psychosocial well-being and sexual well-being is more than 20 with a statistically significant p-value, while in physical well-being the mean difference is 7.8 which falls in little change group. Conclusions: Our study shows that reconstruction helps breast cancer patients in providing comprehensive care in a manner that they achieve a higher satisfaction with their appearance, psychological and sexual well-being without compromising oncological safety and this should be practiced more in our country. Also patients education about these procedures should be raised to help them fighting against this disease


2005 ◽  
Vol 94 (1) ◽  
pp. 21-24 ◽  
Author(s):  
P. Mustonen ◽  
V. Kataja ◽  
M. Berg ◽  
T. Pietiläinen ◽  
A. Papp

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.


Breast Cancer ◽  
2021 ◽  
Author(s):  
L. S. E. van Egdom ◽  
K. M. de Ligt ◽  
L. de Munck ◽  
L. B. Koppert ◽  
M. A. M. Mureau ◽  
...  

Abstract Purpose Delayed breast reconstruction (DBR) is a valid option for postmastectomy breast cancer patients who have a desire for breast reconstruction but are not considered suitable for immediate breast reconstruction (IBR). The objective of this study was to investigate the clinical practice and predictors of the use of DBR in the Netherlands. Methods Stage I–III breast cancer patients diagnosed from January to March 2012 and treated with mastectomy were selected from the Netherlands Cancer Registry. Routinely collected patient, tumor, treatment and hospital characteristics were complemented with data about DBR up to 2018. Multivariable logistic regression analyses were performed to identify factors independently associated with postmastectomy DBR. Factors associated with time to DBR were identified through Cox regression analyses. Results Of all patients who underwent mastectomy (n = 1,415), 10.2% underwent DBR. DBR patients more often received autologous reconstruction compared to IBR patients (37.5% vs 6.2%, p < 0.001). Age below 50 years (age < 35 OR 15.55, age 35–49 OR 4.18) and neoadjuvant and adjuvant chemotherapy (OR 2.59 and OR 2.83, respectively) were significantly associated with DBR. Mean time to DBR was 2.4 years [range 1–6 years]. Time to DBR was significantly associated with age < 35 years (HR 2.22), and a high hospital volume (HR 1.87). Discussion The use of DBR after mastectomy could not be fully explained by age below 50 years, chemotherapy, and hospital volume. Treatment with radiotherapy and adjuvant chemotherapy increased time to DBR. More information about patient preferences is needed to understand the use and timing of reconstruction.


2020 ◽  
pp. 000313482098487
Author(s):  
Melinda Wang ◽  
Julian Huang ◽  
Anees B. Chagpar

Background Patient and tumor characteristics often coincide with obesity, potentially affecting treatment decision-making in obese breast cancer patients. Independent of all of these factors, however, it is unclear whether obesity itself impacts the decision to offer patients undergoing mastectomy breast reconstruction, postmastectomy radiation therapy (PMRT), or neoadjuvant chemotherapy. We sought to determine whether implicit bias against obese breast cancer patients undergoing mastectomy plays a role in their treatment. Methods Medical records of breast cancer patients undergoing mastectomy from January 2010 to April 2018 from a single institution were retrospectively reviewed, separated into obese (BMI ≥30) and nonobese (BMI <30) categories, and compared using nonparametric statistical analyses. Results Of 972 patients, 291 (31.2%) were obese. Obese patients were more likely to have node-positive, triple-negative breast cancers ( P = .026) and were also more likely to have other comorbidities such as a history of smoking ( P = .026), hypertension ( P < .001), and diabetes ( P < .001). Receipt of immediate reconstruction and contralateral prophylactic mastectomy did not vary between obese and nonobese patients. While obese patients were more likely to undergo neoadjuvant chemotherapy (26.5% vs. 18.1%, P = .004) and PMRT (33.0% vs. 23.4%, P = .003), this did not remain significant when controlling for comorbidities and clinicopathologic confounders. Conclusion Obese patients present with more aggressive tumors and often have concomitant comorbidities. Independent of these factors, however, differences in the treatment of patients undergoing mastectomy do not seem to be affected by an implicit bias against obese patients.


2014 ◽  
Vol 72 ◽  
pp. S46-S50 ◽  
Author(s):  
Ryan K. Wong ◽  
Shane D. Morrison ◽  
Arash Momeni ◽  
Matthew Nykiel ◽  
Gordon K. Lee

Sign in / Sign up

Export Citation Format

Share Document