ABSTRACT
PURPOSE: This study was conducted to identify factors influencing patients' decisions to undergo breast reconstruction, and to identify the influences of breast reconstruction on patient behavior and psychological well-being. METHODS: Data were collected from January to June 2011, using a questionnaire distributed to women ≤45 years old with breast cancer, at five medical institutes across Japan. RESULTS: Completed questionnaires were collected from 316 women (mean age: 39.46 ± 4.4 years, range: 27-45 years). Overall, 174 patients received breast-conserving surgery, 101 received mastectomy, 31 received subcutaneous mastectomy, 3 patients received none, and 49 were unreported). The data indicated a reconstruction rate of 36.7 % in women who underwent mastectomy. The most prevalent reason for not undergoing breast reconstruction was the fear of cancer relapse. Other factors mentioned were to avoid additional distress on the body from surgery, financial reasons, and a belief that breast reconstruction is unnecessary. The main factor that influenced the decision not to undergo delayed breast reconstruction, specifically, was the expense. Women who had completed breast reconstruction showed higher self-evaluations of physical attractiveness and were more active in comparison to those who did not. However, regardless of having undergone breast reconstruction or not, women who reported higher levels of self-consciousness over the treated areas showed more restrictions on activity and higher chances of a decline in psychological well-being. CONCLUSION: Regardless of deciding to undergo breast reconstruction or not, the results of this study suggested the need for cognitive interventions to avoid patients fixating on self-consciousness over treated areas.
