Psychosocial Impact Of Delayed Reconstruction After Mastectomy


Women undergoing a mastectomy owed to breast cancer may avoid some psychological distress by, when it’s suitable, opting for immediate breast reconstruction (IBR) instead of delayed breast reconstruction (DBR). This is according to a University of Toronto study.

“Mastectomy with IBR may protect breast cancer patients from a period of psychosocial distress, poor body image, and diminished sexual well-being, compared to those waiting for DBR,” reports researcher Toni Zhong, MD, MHS.

The Toronto study involved breast cancer patients undergoing mastectomy, and subsequent autologous breast reconstruction—a procedure utilizing the patient’s own tissues. Of the 106 participants, 30 underwent IBR immediately after their mastectomy. The remaining 76 DBR patients waited an average of three years post-mastectomy for their reconstructive surgery.

Each participant completed psychological assessment questionnaires before, and at six, 12, and 18 months after mastectomy. An analysis of the assessment scores indicated that mastectomies with IBR, and mastectomies with DBR have different psychological effects.

Following mastectomy, women in the DBR group rated themselves lower in body image, health-related quality of life, and sexuality than the IBR group, indicating a heightened level of psychosocial distress during the interval between mastectomy and reconstruction.

Although DBR may entail increased cognitive and emotional discomfort, this appears to be temporary. Six months after breast reconstruction, no difference in body image between the IBR and DBR groups remained. Sexuality concerns took longer to resolve, but after 18 months the differences in those scores disappeared also.

The issue then, is avoiding a span of unnecessary distress. Dr. Zhong and colleagues conclude that motivated women unlikely to need post-surgical treatment would be wise to consider IBR with mastectomy. When reconstruction must be delayed, the research team suggests the wait-time for reconstruction be short as possible to minimize psychosocial issues.

Source: Plastic Surgery
Photo credit: saturnism


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