ABSTRACT
BACKGROUND: Although breast reconstruction has been shown to improve psychological, physical, and sexual well-being, Australia still has one of the lowest reconstruction rates among well-developed countries. This study explores both the quality-of-life benefits of reconstruction and the factors that influence patients' decisions of whether or not to undergo reconstruction. METHODS: This retrospective cohort study (296 consecutive mastectomy patients from 2000 to 2010) uses an internationally validated questionnaire (BREAST-Q) to evaluate patients' satisfaction with or without breast reconstruction. In addition, we analyzed factors that influence patients' decisions of whether to undergo reconstruction. RESULTS: Two hundred nineteen patients responded (74%) and of the 143 patients who elected to participate, 79 were in the "reconstruction group" and 64 in the "no-reconstruction group" post mastectomy. Patient demographics and cancer variables of the 2 groups were matched with the exception of age (reconstruction group 9.7 years younger: P < 0.01). The reconstruction group showed statistically significantly higher BREAST-Q scores with regard to satisfaction with the breast (P < 0.0001), psychological well-being (P = 0.0068), and sexual well-being (P = 0.0001). For the reconstruction group, the main reasons for undergoing reconstruction included improved self-image, more clothing choices, and the feeling of overcoming the cancer. One third of non-reconstructed patients still feared that reconstruction would mask cancer recurrence. CONCLUSION: Our study confirms the positive effects of breast reconstruction post mastectomy and identifies reasons that influence patients' decisions of whether to undergo reconstruction. Breast reconstruction should be seen as an integral part in the comprehensive care of women with breast cancer and an important health care priority in Australia.
Subject(s)
Decision Making , Mammaplasty/psychology , Mastectomy , Patient Acceptance of Health Care/psychology , Patient Satisfaction/statistics & numerical data , Quality of Life , Adult , Aged , Aged, 80 and over , Australia , Female , Humans , Middle Aged , Patient Reported Outcome Measures , Retrospective StudiesABSTRACT
BACKGROUND: With the introduction of new therapeutic strategies, the survival of children and adolescents with cancer has increased dramatically. However, cancer survivors often experience late effects from their cancer treatment. OBJECTIVE: A case study is presented that highlights the wide range of issues that may be encountered in young cancer survivors and underscores the necessity of continued follow up in this group of patients. DISCUSSION: Risk factors and the recommended surveillance of second cancer in this group of patients are discussed.
