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Patients’ experience of breast reconstruction after mastectomy and its influence on postoperative satisfaction

Archives of Gynecology and Obstetrics volume 296, pages 827–834 (2017)Cite this article

Abstract

Purpose

Breast cancer patients have the option to choose a breast reconstruction after mastectomy. A range of studies have postulated that patients’ individually appraised significance of their breast is an important factor in the decision for or against breast reconstruction. This study explored the individually perceived significance of the breast among patients with and without breast reconstruction and its correlation with postoperative satisfaction.

Methods

Ten patients without breast reconstruction, and ten patients with immediate breast reconstruction after mastectomy participated in the study. The perceived importance of the breast and the pre-and postoperative esthetic satisfaction of the patients were obtained using an 11-point Likert scale. Qualitative interviews explored patients’ views on the meaning of their breast and their experience after surgery.

Results

Patients who had decided for breast reconstruction rated the importance of their breast for femininity (p = 0.004) and attractiveness (p = 0.037) significantly higher than patients without reconstruction. The qualitative data provide evidence that the breast of a woman fulfills a variety of intrapsychic and interactional functions. Difficulties in integrating the reconstructed breast into the body image were reported. A high importance of the breast correlated significantly with a decrease in satisfaction with the breast after reconstruction (rs = −0.652, p = 0.041).

Conclusions

Patients who found their breast to be highly important were more likely to decide for a reconstruction. Mastectomy has an impact on various psychosocial variables but impairments may also occur after breast reconstruction. Patients reporting a high significance of their breast showed the greatest decrease in satisfaction with their breast after reconstruction.

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Author information

Affiliations

  1. Department of Gynaecology and Obstetrics, University Medical Centre Regensburg, Landshuter Straße 65, 93053, Regensburg, Germany

    Jana L. Schmidt, Cordula M. Wetzel & Olaf Ortmann

  2. Department of Experimental Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany

    Klaus W. Lange

  3. Department of Plastic Surgery, University Medical Centre Regensburg, Landshuter Straße 65, 93053, Regensburg, Germany

    Norbert Heine

Authors
  1. Jana L. Schmidt
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  2. Cordula M. Wetzel
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  3. Klaus W. Lange
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  4. Norbert Heine
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  5. Olaf Ortmann
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Contributions

JLS: Project development, Data collection, Data analysis, Manuscript writing. CMW: Project development, Manuscript editing. KWL: Project development. NH: Project development. OO: Project development, Manuscript editing.

Corresponding author

Correspondence to Jana L. Schmidt.

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Funding

This study was not funded.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Schmidt, J.L., Wetzel, C.M., Lange, K.W. et al. Patients’ experience of breast reconstruction after mastectomy and its influence on postoperative satisfaction. Arch Gynecol Obstet 296, 827–834 (2017). https://doi.org/10.1007/s00404-017-4495-5

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  • DOI: https://doi.org/10.1007/s00404-017-4495-5

Keywords

  • Breast cancer
  • Breast reconstruction
  • Femininity
  • Sexuality
  • Satisfaction
  • Impairments