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Changes in Psychosocial Functioning 1 Year After Mastectomy Alone, Delayed Breast Reconstruction, or Immediate Breast Reconstruction

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

In this study, we report on the changes in psychosocial functioning over 1 year following breast cancer surgery in 3 groups of women, including those with mastectomy alone, those with mastectomy and immediate reconstruction, and those with delayed reconstruction.

Methods

Women with breast cancer at 2 teaching hospitals in Ontario who were undergoing mastectomy alone, mastectomy with immediate reconstruction, or delayed reconstruction were asked to complete a battery of psychosocial questionnaires at their preoperative appointment and 1 year following surgery.

Results

A total of 190 women consented to participate in the study and completed the presurgical questionnaires. There were no presurgical differences between the 3 groups in quality of life, anxiety, depression, or sexual functioning. However, women who were undergoing delayed breast reconstruction (i.e., already had a mastectomy) had higher levels of body stigma (P = 0.01), body concerns (P = 0.002), and transparency (P = 0.002) than women who were undergoing mastectomy alone or mastectomy with immediate reconstruction. Of these women, 158 (83.2%) completed the 1-year follow-up. There were no significant differences in any of the psychosocial functioning scores between the 3 groups.

Discussion

Contrary to the assumed psychological benefits of breast reconstruction, psychological distress was evident among women regardless of reconstruction or timing of reconstruction. Further, psychosocial functioning (including quality of life, sexual functioning, cancer-related distress, body image, depression, and anxiety) was not different at 1-year postsurgery between women with mastectomy alone, mastectomy with immediate reconstruction, and delayed reconstruction. These results suggest that women need psychosocial support after breast cancer diagnosis, even if they have breast reconstruction.

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Acknowledgment

We wish to acknowledge the Canadian Breast Cancer Foundation (Ontario Chapter) for funding this study. Dr. Metcalfe is supported by the Canadian Institutes of Health Research and the Ontario Women’s Health Council.

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Authors and Affiliations

  1. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada

    Kelly A. Metcalfe RN, PhD

  2. Women’s College Research Institute, Toronto, Canada

    Kelly A. Metcalfe RN, PhD, John Semple MD, Mitch Brown MD, Ping Sun PhD & Steven A. Narod MD

  3. Foothills Medical Centre, Calgary, Canada

    May-Lynn Quan MD

  4. Moffitt Cancer Center, Tampa, USA

    Susan T. Vadaparampil PhD & Bethanne Bower BA

  5. Sunnybrook Regional Cancer Centre, Toronto, Canada

    Claire Holloway MD

Authors
  1. Kelly A. Metcalfe RN, PhD
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  2. John Semple MD
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  3. May-Lynn Quan MD
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  4. Susan T. Vadaparampil PhD
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  5. Claire Holloway MD
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  6. Mitch Brown MD
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  7. Bethanne Bower BA
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  8. Ping Sun PhD
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  9. Steven A. Narod MD
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Corresponding authors

Correspondence to Kelly A. Metcalfe RN, PhD or Steven A. Narod MD.

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Metcalfe, K.A., Semple, J., Quan, ML. et al. Changes in Psychosocial Functioning 1 Year After Mastectomy Alone, Delayed Breast Reconstruction, or Immediate Breast Reconstruction. Ann Surg Oncol 19, 233–241 (2012). https://doi.org/10.1245/s10434-011-1828-7

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  • DOI: https://doi.org/10.1245/s10434-011-1828-7

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