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A prospective study of mastectomy patients with and without delayed breast reconstruction: Long‐term psychosocial functioning in the breast cancer survivorship period
Author(s) -
Metcalfe Kelly A.,
Zhong Toni,
Narod Steven A.,
Quan MayLynn,
Holloway Claire,
Hofer Stefan,
Bagher Shaghayegh,
Semple John
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23829
Subject(s) - mastectomy , medicine , psychosocial , breast cancer , prospective cohort study , distress , quality of life (healthcare) , survivorship curve , breast reconstruction , cancer , surgery , psychiatry , clinical psychology , nursing
For women who have mastectomy, breast reconstruction is an option which may improve psychosocial functioning. The purpose of this study was to evaluate changes in psychosocial functioning over a long follow‐up period after mastectomy, specifically examining the differences between those with mastectomy alone and those who underwent postmastectomy delayed breast reconstruction (DBR). Methods This was a prospective longitudinal survey study of women with mastectomy in which a repeated measures design was used to compare psychosocial function scores over 3 timepoints: 1) pre‐mastectomy; 2) one year post‐mastectomy; and 3) long‐term post‐mastectomy (mean 6.3 years). In addition, psychosocial functioning was compared between the mastectomy alone group and the group who elected for DBR. Results 67 women who completed questionnaires at all three time points were included. The long‐term follow‐up time post‐mastectomy was 75.2 months (6.3 years). Twenty‐eight women (41.8%) underwent DBR in the study period. For the entire cohort, between one‐year and long‐term post‐mastectomy, there were significant improvements in scores for body concerns ( P = 0.03), cancer‐related distress ( P = 0.01), and total distress ( P = 0.04). At long‐term follow‐up, women with DBR had significantly higher levels of total distress ( P = 0.01), obsessiveness ( P = 0.03), and cancer‐related distress ( P = 0.02) compared to those with mastectomy alone. There were no differences in quality of life between the two groups at any time point. Conclusions Psychosocial functioning improves over time in patients treated with mastectomy in the long‐term breast cancer survivorship period, which may be related to the effect of time post‐treatment, rather than an effect of choice for or against DBR. J. Surg. Oncol. 2015 111:258–264 . © 2014 Wiley Periodicals, Inc.