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J Surg Oncol. 2015 Mar;111(3):258-64. doi: 10.1002/jso.23829. Epub 2014 Dec 29.

A prospective study of mastectomy patients with and without delayed breast reconstruction: long-term psychosocial functioning in the breast cancer survivorship period.

Author information

1
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Women's College Research Institute, Toronto, Canada; Faculty of Medicine, Department of Surgery in the Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Canada.

Abstract

INTRODUCTION:

For women who have mastectomy, breast reconstruction is an option which may improve psychosocial functioning. The purpose of this study was to evaluate changes in psychosocial functioning over a long follow-up period after mastectomy, specifically examining the differences between those with mastectomy alone and those who underwent postmastectomy delayed breast reconstruction (DBR).

METHODS:

This was a prospective longitudinal survey study of women with mastectomy in which a repeated measures design was used to compare psychosocial function scores over 3 timepoints: 1) pre-mastectomy; 2) one year post-mastectomy; and 3) long-term post-mastectomy (mean 6.3 years). In addition, psychosocial functioning was compared between the mastectomy alone group and the group who elected for DBR.

RESULTS:

67 women who completed questionnaires at all three time points were included. The long-term follow-up time post-mastectomy was 75.2 months (6.3 years). Twenty-eight women (41.8%) underwent DBR in the study period. For the entire cohort, between one-year and long-term post-mastectomy, there were significant improvements in scores for body concerns (P = 0.03), cancer-related distress (P = 0.01), and total distress (P = 0.04). At long-term follow-up, women with DBR had significantly higher levels of total distress (P = 0.01), obsessiveness (P = 0.03), and cancer-related distress (P = 0.02) compared to those with mastectomy alone. There were no differences in quality of life between the two groups at any time point.

CONCLUSIONS:

Psychosocial functioning improves over time in patients treated with mastectomy in the long-term breast cancer survivorship period, which may be related to the effect of time post-treatment, rather than an effect of choice for or against DBR.

KEYWORDS:

Breast cancer surgery; Cognitive and emotional status; Plastic surgery

PMID:
25557452
DOI:
10.1002/jso.23829
[Indexed for MEDLINE]

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