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BRAGANHOLO, L. P. Not having breast reconstruction: factors involved, quality of life and self-esteem. 2007. 133f. Dissertation (Master) – School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 2007. Introduction: The goal of breast reconstruction is to improve woman’s quality of life and self-esteem after breast cancer. Nowadays, there are fewer women that underwent this surgery, and few studies had investigated the reason why woman do not choose this procedure. Objective: Describe the factors involved to not having breast reconstruction and to investigate the woman’s quality of life and self-esteem after breast cancer surgery. Methods: A sample of 53 women that underwent breast cancer surgery, taking part of a rehabilitation center during the period of august until december 2006, answered a questionnaire that included information about the disease, treatment and questions about why they did not have breast reconstruction. The Medical Outcomes Study 36-item Sort Form Health Survey – MOS-SF36 – and Rosemberg Self-Esteem Scale was administered. Results: The majority of the women was 50 years or older, married, white, low educational level and low economic status. Most woman underwent mastectomy and the average time since surgery was 5.8 years. The majority of the women received radiotherapy and chemotherapy and some of them had limitation of the movements and home activities, lymphedema, pain and others complications. About breast reconstruction surgery, all women had heard about it, but not all of them received information from their physicians about this possibility before breast surgery. Health professionals were related to be the more main source of information by woman and this was also the group that they had less discussion with. Most women knew about their right of having breast reconstruction by the public health care system, but claimed that the surgery is long, that multiple surgeries are needed and that the prosthesis can be rejected by their bodies. The majority of the women revealed fear of complications associated with the reconstruction and said that they would have not done the surgery, although they feel they are in a correct age and use external prosthesis. Most women did not have active sexual life and were satisfied with their body image. Most of them expressed freedom to wear any clothing and feel comfortable when fully dressed, with swim cloths or naked. About support groups, there were positive changes in the relationship with family and partner after breast cancer surgery. The MOS-SF36 showed lowest score to “bodily pain”, “role-physical”, “vitality”, “mental health” and “physical functioning”. Rosemberg Self-Esteem Scale received 34.4 average score. Conclusions: This study suggests woman’s adaptation to the consequences of breast cancer treatment, not giving importance to breast reconstruction. Key-words: Mastectomy. Mammaplasty. Breast Neoplasms. Rehabilitation. Quality of life.

A não realização de cirurgia reconstrutiva de mama: fatores associados, qualidade de vida e auto-estima