Abstract
Purpose
Breast cancer patients have the option to choose a breast reconstruction after mastectomy. A range of studies have postulated that patients’ individually appraised significance of their breast is an important factor in the decision for or against breast reconstruction. This study explored the individually perceived significance of the breast among patients with and without breast reconstruction and its correlation with postoperative satisfaction.
Methods
Ten patients without breast reconstruction, and ten patients with immediate breast reconstruction after mastectomy participated in the study. The perceived importance of the breast and the pre-and postoperative esthetic satisfaction of the patients were obtained using an 11-point Likert scale. Qualitative interviews explored patients’ views on the meaning of their breast and their experience after surgery.
Results
Patients who had decided for breast reconstruction rated the importance of their breast for femininity (p = 0.004) and attractiveness (p = 0.037) significantly higher than patients without reconstruction. The qualitative data provide evidence that the breast of a woman fulfills a variety of intrapsychic and interactional functions. Difficulties in integrating the reconstructed breast into the body image were reported. A high importance of the breast correlated significantly with a decrease in satisfaction with the breast after reconstruction (rs = −0.652, p = 0.041).
Conclusions
Patients who found their breast to be highly important were more likely to decide for a reconstruction. Mastectomy has an impact on various psychosocial variables but impairments may also occur after breast reconstruction. Patients reporting a high significance of their breast showed the greatest decrease in satisfaction with their breast after reconstruction.
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JLS: Project development, Data collection, Data analysis, Manuscript writing. CMW: Project development, Manuscript editing. KWL: Project development. NH: Project development. OO: Project development, Manuscript editing.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.
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Informed consent was obtained from all individual participants included in the study.
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Schmidt, J.L., Wetzel, C.M., Lange, K.W. et al. Patients’ experience of breast reconstruction after mastectomy and its influence on postoperative satisfaction. Arch Gynecol Obstet 296, 827–834 (2017). https://doi.org/10.1007/s00404-017-4495-5
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DOI: https://doi.org/10.1007/s00404-017-4495-5