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Psychosocial Functioning in Women with Early Breast Cancer Treated with Breast Surgery With or Without Immediate Breast Reconstruction

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To compare psychosocial function outcomes in early breast cancer patients treated with breast-conserving surgery (BCS), mastectomy alone (MA), and mastectomy with immediate breast reconstruction (IBR) at 1 year after surgery.

Methods

Early-stage (stage 0–2) breast cancer patients treated with BCS, MA, and IBR at the University Health Network, Toronto, Ontario, Canada between May 1 2015 and July 31 2016 were prospectively enrolled. Their changes in psychosocial functioning from baseline to 12 months following surgery were compared by using the BREAST-Q, Hospital Anxiety and Depression Scale, and Impact of Event Scale with ANOVA and linear regression.

Results

There were 303 early-stage breast cancer patients: 155 underwent BCS, 78 MA, and 70 IBR. After multivariable regression accounting for age, baseline score, income, education, receipt of chemoradiation or hormonal therapy, ethnicity, cancer stage, and unilateral versus bilateral surgery, breast satisfaction was highest in BCS (72.1, SD 19.6), followed by IBR (60.0, SD 18.0), and MA (49.9, SD 78.0) at 12 months, p < 0.001. Immediate breast reconstruction had similar psychosocial well-being (69.9, SD 20.6) compared with BCS (78.5, SD 20.6), p = 0.07. Sexual and chest physical well-being were similar between IBR, BCS, and MA, p > 0.05.

Conclusions

Our study found that in a multidisciplinary breast cancer centre where all three breast ablative and reconstruction options are available to early breast cancer patients, either BCS or IBR can be used to provide patients with a higher degree of satisfaction and psychosocial well-being compared with MA in the long-term.

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Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Toronto General Hospital, Toronto, ON, Canada

    Helene Retrouvey MDCM, Anne C. O’Neill MBBCh, MMedSci, MSc, FRCS, PhD, Stefan O. P. Hofer MD, PhD, FRCS(C) & Toni Zhong MD, MHS, FRCS(C)

  2. Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada

    Isabel Kerrebijn BSc

  3. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Women’s College Research Institute, Toronto, Canada

    Kelly A. Metcalfe RN, PhD

  4. Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada

    David R. McCready MD, FRCSC

Authors
  1. Helene Retrouvey MDCM
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  2. Isabel Kerrebijn BSc
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  3. Kelly A. Metcalfe RN, PhD
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  4. Anne C. O’Neill MBBCh, MMedSci, MSc, FRCS, PhD
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Correspondence to Toni Zhong MD, MHS, FRCS(C).

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DISCLOSURE

Dr. Toni Zhong is the Belinda Stronach Chair of University Health Network Breast Cancer Reconstructive Surgery and the recipient of the Canadian Institutes of Health Research (CIHR), Foundation Scheme Live Pilot.

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Retrouvey, H., Kerrebijn, I., Metcalfe, K.A. et al. Psychosocial Functioning in Women with Early Breast Cancer Treated with Breast Surgery With or Without Immediate Breast Reconstruction. Ann Surg Oncol 26, 2444–2451 (2019). https://doi.org/10.1245/s10434-019-07251-9

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  • DOI: https://doi.org/10.1245/s10434-019-07251-9

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