Prospective Analysis of Psychological Changes in Patients Undergone Free TRAM Breast Reconstruction

ABSTRACT

This study was performed to report psychosocial aspects of breast reconstruction patients through the prospective analysis. Total 35 patients who underwent reconstruction with free TRAM flap were surveyed from October, 1999 to January, 2003. Patients were surveyed by questionnaires both before reconstruction and 1 year after reconstruction. These questionnaires consisted of 6 parts. The delayed reconstruction group had more expectations about the operation than the immediate reconstruction group. Preoperative body image of the delayed reconstruction group showed more negative aspects than the immediate reconstruction group, which means that the reconstruction of breast helps the patient's body image change in a positive way. Psychological status was improved in both groups in terms of somatization, obsessive-compulsive, depression and anxieties. The satisfaction of the operation was higher in delayed reconstruction group than in the immediate reconstruction group in subjective evaluation. Regarding the quality of life, physical health domain was improved after reconstruction in the immediate group. On the other hand, not only physical health domain but also psychological domain and social relationships domains were improved in the delayed group. To sum up, results of this study show differences between both groups according to the reconstructive time. Nevertheless, in both breast reconstruction groups the body image, psychological state, and quality of life were improved. This study reports that breast reconstruction contributes to improve psychosocial aspects as well as to correct physical deformity.