scholarly journals Quality of Life after Bilateral and Contralateral Prophylactic Mastectomy with Implant Reconstruction

Breast Care ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. 519-526
Author(s):  
Rüdiger Klapdor ◽  
Christina Weiß ◽  
Elna Kuehnle ◽  
Fabian Kohls ◽  
Julia von Ehr ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
High Risk ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Well Being ◽  
Bilateral Mastectomy ◽  
Patient Counseling ◽  
Postoperative Score

Background: Prophylactic mastectomy is an effective approach to breast cancer risk reduction in patients at high risk. Further studies using standardized measures for quality of life are needed to better understand the effect of prophylactic mastectomy on individual patients and, thereby, allow for better patient counseling and selection. Methods: In this prospective study patients undergoing bilateral mastectomy were asked to complete the BREAST-Q questionnaire before and 1 year after surgery. All patients underwent bilateral mastectomy with implant-based breast reconstruction. Patient- and surgery-related information was collected in a database. Results: In total, 48 patients underwent bilateral skin-sparing mastectomy. Of these, 29 (60.4%) suffered from breast cancer. A 2-stage reconstruction with intermediate expander implantation was conducted in 19 (39.6%) patients. All patients completed the BREAST-Q questionnaire. The domain “psychosocial well-being” was significantly improved from a mean score of 74.98 preoperatively to a postoperative score of 81.56 (p = 0.021). In contrast, the domain “physical well-being” dropped –8.38 points on average to a postoperative score of 74.96 (p < 0.001). Interestingly, patients with the lowest preoperative score in the domain “satisfaction with breast” showed the greatest increase after surgery (50.31 vs. 67.25, p < 0.001). On the contrary, patients with the highest preoperative values experienced the strongest decrease in satisfaction (91.60 vs. 75.27, p = 0.012). Conclusion: Implant-based prophylactic mastectomy leads to good quality-of-life results in patients at high risk for breast cancer. Especially, patients with a low preoperative satisfaction with their breasts have a significantly higher chance of experiencing substantial improvements in their quality of life.

Quality of Life After Contralateral Prophylactic Mastectomy in Newly Diagnosed High-Risk Breast Cancer Patients Who Underwent BRCA1/2 Gene Testing

2007 ◽  
Vol 25 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Kenneth P. Tercyak ◽  
Beth N. Peshkin ◽  
Barbara M. Brogan ◽  
Tiffani DeMarco ◽  
Marie F. Pennanen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
High Risk ◽  
Cancer Patients ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Breast Cancer Patients ◽  
High Risk Breast Cancer ◽  
Risk Breast Cancer

Purpose Recent studies indicate that high-risk breast cancer patients (ie, women who carry mutations in BRCA1/2 genes) who opt for contralateral prophylactic mastectomy (CPM) have a substantially reduced risk of developing contralateral breast cancer. However, the immediate and long-term impact of this decision on women's quality of life and psychosocial functioning is largely unknown. In this study, we compared the impact of BRCA1/2 genetic test result and CPM on these outcomes among newly diagnosed breast cancer patients who opted for CPM at the time of their definitive surgical treatment versus patients who did not. Patients and Methods Participants were 149 high-risk women who underwent genetic counseling and testing for alterations in the BRCA1/2 genes. We measured self-reported quality of life, cancer-specific distress, and genetic testing–specific distress using standardized instruments before receipt of genetic test results and again 1 and 12 months later. Results Compared with patients who chose breast conservation or unilateral mastectomy, those who chose mastectomy of the affected breast and CPM of the unaffected breast did not report diminished quality of life or elevated distress. Conclusion With respect to quality of life and distress, patients who choose CPM fare as well as those who do not in the first year after surgery.

Contentment With Quality of Life Among Breast Cancer Survivors With and Without Contralateral Prophylactic Mastectomy

2006 ◽  
Vol 24 (9) ◽  
pp. 1350-1356 ◽  
Author(s):  
Ann M. Geiger ◽  
Carmen N. West ◽  
Larissa Nekhlyudov ◽  
Lisa J. Herrinton ◽  
In-Liu A. Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Prophylactic Mastectomy ◽  
Care Delivery ◽  
Contralateral Prophylactic Mastectomy ◽  
Psychosocial Outcomes ◽  
Health Perception

Purpose To understand psychosocial outcomes after prophylactic removal of the contralateral breast in women with unilateral breast cancer. Methods We mailed surveys to women with contralateral prophylactic mastectomy after breast cancer diagnosis between 1979 and 1999 at six health care delivery systems, and to a smaller random sample of women with breast cancer without the procedure. Measures were modeled on instruments developed to assess contentment with quality of life, body image, sexual satisfaction, breast cancer concern, depression, and health perception. We examined associations between quality of life and the other domains using logistic regression. Results The response rate was 72.6%. Among 519 women who underwent contralateral prophylactic mastectomy, 86.5% were satisfied with their decision; 76.3% reported high contentment with quality of life compared with 75.4% of 61 women who did not undergo the procedure (P = .88). Among all case subjects, less contentment with quality of life was not associated with contralateral prophylactic mastectomy or demographic characteristics, but was associated with poor or fair general health perception (odds ratio [OR], 7.0; 95% CI, 3.4 to 14.1); possible depression (OR, 5.4; 95% CI, 3.1 to 9.2); dissatisfaction with appearance when dressed (OR, 3.5; 95% CI, 2.0 to 6.0); self-consciousness about appearance (OR, 2.0; 95% CI, 1.1 to 3.7); and avoiding thoughts about breast cancer (modest: OR, 2.2; 95% CI, 1.1 to 4.5; highest: OR, 1.7; 95% CI, 0.9 to 3.2). Conclusion Most women undergoing contralateral prophylactic mastectomy report satisfaction with their decision and experience psychosocial outcomes similar to breast cancer survivors without the procedure.

scholarly journals Psychosocial and Aesthetic Advantages of Reconstruction after Prophylactic Mastectomy: A Quality of Life and Aesthetic Analysis

2017 ◽  
Vol 33 (07) ◽  
pp. 483-492
Author(s):  
Michele Manahan ◽  
Pablo Baltodano ◽  
Myrna Reinhardt ◽  
Li Xie ◽  
Justin Muste ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chart Review ◽  
Postoperative Morbidity ◽  
Prophylactic Mastectomy ◽  
Retrospective Chart Review ◽  
Well Being ◽  
Patient Counseling ◽  
Aesthetic Evaluation

Background Proper patient counseling regarding reconstruction after prophylactic mastectomy (PM) requires greater understanding of quality of life (QoL) and aesthetic outcomes. Our study evaluates these end points using the validated BREAST-Q and Garbay system. Methods We performed a retrospective chart review of 1,254 mastectomy patients (July 2008 through July 2012). Of those with completed preoperative BREAST-Q and reconstruction with a minimum of 6-month follow-up, 18 underwent bilateral PM (BPM), 36 underwent contralateral PM (CPM), and 30 matched controls were selected who underwent unilateral therapeutic mastectomy (TM) with contralateral symmetry procedure. Preoperative and 6-month postreconstruction BREAST-Q scores were compared within and between groups. Subsequently, aesthetic evaluation of 21 of a group of randomly selected reconstructions (7 TM, 7 CPM, and 7 BPM) was performed by 14 plastic surgery researchers. Potential correlations between aesthetic evaluations and QoL outcomes were examined. Results Demographic characteristics, preoperative satisfaction scores, and postoperative morbidity rates were similar among all three groups. Although reconstruction after BPM was associated with improved aesthetic outcomes (p < 0.001), a significant postoperative increase in satisfaction with breasts was noted only in the TM group (p = 0.006). CPM was associated with improved psychosocial well-being (p = 0.039) in our study. No further significant differences were noted. Conclusion Although BPM with reconstruction is associated with higher aesthetic outcomes compared with CPM or TM, QoL is not significantly increased. Reconstruction after CPM, but not BPM, is associated with increased psychosocial well-being. These valuable findings should be taken into account during preoperative counseling regarding elective PMs.

Patient-Reported Outcomes After Choice for Contralateral Prophylactic Mastectomy

2016 ◽  
Vol 34 (13) ◽  
pp. 1518-1527 ◽  
Author(s):  
E. Shelley Hwang ◽  
Tracie D. Locklear ◽  
Christel N. Rushing ◽  
Greg Samsa ◽  
Amy P. Abernethy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Reported Outcomes ◽  
Prophylactic Mastectomy ◽  
Multivariable Analysis ◽  
Contralateral Prophylactic Mastectomy ◽  
Well Being ◽  
Breast Cancer Surgery ◽  
Patient Reported ◽  
History Of

Purpose The rate of contralateral prophylactic mastectomies (CPMs) continues to rise, although there is little evidence to support improvement in quality of life (QOL) with CPM. We sought to ascertain whether patient-reported outcomes and, more specifically, QOL differed according to receipt of CPM. Methods Volunteers recruited from the Army of Women with a history of breast cancer surgery took an electronically administered survey, which included the BREAST-Q, a well-validated breast surgery outcomes patient-reporting tool, and demographic and treatment-related questions. Descriptive statistics, hypothesis testing, and regression analysis were used to evaluate the association of CPM with four BREAST-Q QOL domains. Results A total of 7,619 women completed questionnaires; of those eligible, 3,977 had a mastectomy and 1,598 reported receipt of CPM. Women undergoing CPM were younger than those who did not choose CPM. On unadjusted analysis, mean breast satisfaction was higher in the CPM group (60.4 v 57.9, P < .001) and mean physical well-being was lower in the CPM group (74.6 v 76.6, P < .001). On multivariable analysis, the CPM group continued to report higher breast satisfaction (P = .046) and psychosocial well-being (P = .017), but no difference was reported in the no-CPM group in the other QOL domains. Conclusion Choice for CPM was associated with an improvement in breast satisfaction and psychosocial well-being. However, the magnitude of the effect may be too small to be clinically meaningful. Such patient-reported outcomes data are important to consider when counseling women contemplating CPM as part of their breast cancer treatment.

scholarly journals Symptom Experience and Quality of Life of Patients with Breast Cancer Receiving Chemotherapy in Bangladesh

2016 ◽  
Vol 15 (2) ◽  
pp. 201-206
Author(s):  
Mosammat Shamsun Naher Begum ◽  
Wongchan Petpichetchian ◽  
Luppana Kitrungrote
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Medical Science ◽  
Well Being ◽  
Significant Negative Correlation ◽  
Moderate Level ◽  
Self Report ◽  
Symptom Experience ◽  
Breast Cancer Patients

Background: The present study was aimed to the relationships between symptom severity and distress and quality of life (QoL) of patients receiving chemotherapy for breast cancer.Objectives and methodology: A total number of 132 patients, attending both In-patient and Out-patient department and fulfilling the recruitment criteria were included in the study. A self-report questionnaire was used to collect data from the eligible participants by the primary investigator. The data were analyzed by using descriptive and inferential statistical tools. Results: On average, the participants of the study experienced seventeen symptoms with moderate level. The level of QoL of the participants was at moderate level (M=2.02, SD=0.39). Among all the subscales, the physical well-being had the lowest score and social well-being had highest score. Symptom experience and quality of life showed significant negative correlation. Conclusion: The patients with breast cancer would experience high symptoms during a 7-day period after receiving chemotherapy of the previous cycle. Nurses need to perform full measurement of multiple symptoms when care for breast cancer patients after the administration of chemotherapy.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.201-206

scholarly journals Evaluation of women’s quality of life after breast reconstruction surgery

2020 ◽  
Vol 66 (2) ◽  
Author(s):  
Marta Stanisz ◽  
Ewelina Kolak ◽  
Dorota Branecka-Woźniak ◽  
Renata Robaszkiewicz-Boukaz ◽  
Przemysław Ciepiela ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Reconstruction ◽  
Great Influence ◽  
Well Being ◽  
World Health ◽  
World Health Organization Quality ◽  
Reconstruction Surgery ◽  
The Impact

Introduction: Breast cancer is the most common malignancy among women, and is usually treated surgically. Mastectomy has a great influence on the mental and physical condition of women. Breast reconstruction offers them a chance to improve their quality of life (QOL) and self-image.The main aim of the study was to gain knowledge about the impact of breast reconstruction on the QOL of women following mastectomy, and an analysis of the QOL after breast reconstruction, in the context of prosthesis effect assessment.Materials and methods: The study comprised 100 women following breast reconstructive surgery involved in 1 of the 7 “Amazon Clubs” (post-mastectomy women’s associations) in the West Pomeranian Voivodeship, northwest Poland. The study was based on the author’s questionnaire, and a shortened standardized version of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Statistical calculations were performed with StatSoft Statistica v10 software, adopting a significance level of p < 0.05.Results: The women who decided to have breast reconstruction surgery, noticed improved well-being (67%) and experiencedan increase in self-confidence (61%). The vast majority ofthe patients surveyed (93%) were satisfied with the effectof the prosthesis. Statistically significant differences in QOL were observed in the following spheres: rest and sleep, work capacity, negative feelings, and financial resources (p < 0.05) in relation to the evaluation of the prosthesis effect.Conclusions: 1. Breast reconstruction has a positive influence on improvements in well-being, increasing self-esteem, and the assessment of a more attractive appearance in women of all ages. 2. Breast reconstruction surgery has a positive impact on QOL and health in the physical, psychological, and environmental domains, especially in the women who are satisfied with the effects of the surgery. 3. A negative assessment of the breast reconstruction effect has an adverse influence on QOL. Identifying the factors affecting dissatisfaction with the post-operative outcome is crucial for a complete understanding of the subject, and for implementing measures aimed at improving the QOL of these women.Keywords: quality of life; mastectomy; breast cancer; breast reconstruction; breast surgery.

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