Skip to main content

Advertisement

SpringerLink
Log in

Women’s expectations of breast reconstruction following mastectomy for breast cancer: a systematic review

  • Review Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Breast reconstruction (BR) makes an important positive contribution to the quality of life of many women who have undergone mastectomy for breast cancer. The purpose of this article is to evaluate the evidence for possible relationships between women’s expectations of BR and their satisfaction with outcomes to inform and facilitate improved communication about BR options prior to initial surgery.

Methods

A systematic review of the literature reporting expectations of BR published between 1 January 1994 and 6 March 2017 identified 2107 initial search results. Twenty-one publications, reporting 20 studies (2288 participants), satisfied the selection criteria. Information on study aim and time frame, participation rate, design/methods, limitations/bias, results and conclusions, as well as participant clinical and demographic information, was reported. An overall quality score was generated for each study.

Results

Four of five studies that quantified expectations and satisfaction found a positive relationship between the two. This may indicate a possible trend, but as 16 of the 21 included publications did not provide quantifiable data, no firm conclusions are possible.

Conclusion

Our findings have important implications for policy and practice which are applicable to medical decision-making more broadly. There is a clear need to utilise accurate and consistent measures of patient-reported expectations and to educate both patients and health practitioners about the importance of informed discussion about treatment options. This is particularly salient for women facing a choice about BR, a major breast cancer survivorship decision. Routine use of an expectations checklist in pre-operative consultations may be useful.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Howes BHL, Watson DI, Xu C, Fosh B, Canepa M, Dean NR (2016) Quality of life following total mastectomy with and without reconstruction versus breast-conserving surgery for breast cancer: a case-controlled cohort study. J Plast Reconstr Aesth Surg 69:1184–1191

    Article  Google Scholar 

  2. National Clinical Audit Support Programme (NCASP) (2009) National mastectomy and breast reconstruction audit (report 2). The Information Centre (NHS), London

    Google Scholar 

  3. Musgrave KJ, Bochner M, Kollias J (2010) Surgical decision-making in immediate breast reconstruction. World J Surg 34:3029–3035

    Article  PubMed  Google Scholar 

  4. Cordeiro PG (2008) Breast reconstruction after surgery for breast cancer. New Eng J Med 359:1590–1601

    Article  CAS  PubMed  Google Scholar 

  5. Nano MT, Gill PG, Kollias J, Bochner MA, Malycha P, Winefield HR (2005) Psychological impact and cosmetic outcome of surgical breast cancer strategies. ANZ J Surg 75:940–947

    Article  PubMed  Google Scholar 

  6. Rowland JH, Holland JC, Chaglassian T, Kinne D (1993) Psychological response to breast reconstruction: expectations for and impact on postmastectomy functioning. Psychosomatics 34(3):241–250

    Article  CAS  PubMed  Google Scholar 

  7. Harcourt DM, Rumsey NJ, Ambler NR, Cawthorn SJ, Reid CD, Maddox PR, Kenealy JM, Rainsbury RM, Umpleby HC (2003) The psychological effect of mastectomy with or without breast reconstruction: a prospective, multicenter study. Plast Reconstr Surg 111:1060–1068

    Article  PubMed  Google Scholar 

  8. Brandberg Y, Malm M, Blomqvist L (2000) A prospective randomised study, “SVEA”, comparing effects of three methods of delayed breast reconstruction on quality of life, patient-defined problem areas of life, and cosmetic result. Plast Reconstr Surg 105:66–74

    Article  CAS  PubMed  Google Scholar 

  9. Hart AM, Pinell-White X, Egro FM, Losken A (2015) The psychosexual impact of partial and total breast reconstruction. A prospective one-year longitudinal study. Ann Plast Surg 75(3):281–286

    Article  CAS  PubMed  Google Scholar 

  10. Wilkins EG, Cederna PS, Lowery JC, Davis JA, Kim HM, Roth RS, Goldfarb S, Izenberg PH, Houin HP, Shaheen KW (2000) Prospective analysis of psychosocial outcomes in breast reconstruction: one-year postoperative results from the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg 106:1014–1025

    Article  CAS  PubMed  Google Scholar 

  11. Temple-Oberle C, Ayeni O, Webb C, Bettger-Hahn M, Ayeni O, Mychailyshyn N (2014) Shared decision-making: applying a person-centred approach to tailored breast reconstruction information provides high satisfaction across a variety of breast reconstruction options. J Surg Oncol 110:796–800

    Article  PubMed  Google Scholar 

  12. Roth RS, Lowery JC, Davis J, Wilkins EG (2007) Psychological factors predict patient satisfaction with postmastectomy breast reconstruction. Plast Reconstr Surg 119:2008–2017

    Article  CAS  PubMed  Google Scholar 

  13. Kim MK, Kim T, Moon HG, Jin US, Kim K, Kim J, Lee JW, Kim J, Lee E, Yoo TK, Noh D-Y, Minn KW, Han W (2015) Effect of cosmetic outcome on quality of life after breast cancer surgery. Eur J Surg Oncol 41:426–432

    Article  CAS  PubMed  Google Scholar 

  14. Pusic AL, Klassen AF, Snell L, Cano SJ, McCarthy C, Scott A, Cemal Y, Rubin LR, Cordeiro PG (2012) Measuring and managing patient expectations for breast reconstruction: impact on quality of life and patient satisfaction. Expert Rev Pharmacoecon Outcomes Res 12(2):149–158

    Article  PubMed  PubMed Central  Google Scholar 

  15. Guyomard V, Leinster S, Wilkinson M, Servant J-M, Pereira J (2009) A Franco-British patients’ and partners’ satisfaction audit of breast reconstruction. J Plast Reconstr, Aesth Surg 62:782–789

    Article  CAS  Google Scholar 

  16. Schain WS, Jacobs E, Wellisch DK (1984) Psychosocial issues in breast reconstruction: intrapsychic, interpersonal, and practical concerns. Clin Plast Surg 2:237–251

    Google Scholar 

  17. Thompson AGH, Suńol R (1995) Expectations as determinants of patient satisfaction: concepts, theory and evidence. Int J Quality in Health Care 7(2):127–141

    Article  CAS  Google Scholar 

  18. Moher D, Liberati A, Tezlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e97

    Article  Google Scholar 

  19. Kmet LM, Lee RC, Cook Linda S. (2004) Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Alberta Heritage Foundation for Medical Research. Health Technology Assessment Initiative No. 13. Alberta, Canada

  20. Daly J, Willis K, Small R, Green J, Welch N, Kealy M, Hughes E (2007) A hierarchy of evidence for assessing qualitative health research. J Clin Epidemiol 60:43–49

    Article  PubMed  Google Scholar 

  21. Brandberg Y, Malm M, Rutqvist E, Jonsson E, Blomqvist L (1999) A prospective randomised study (named SVEA) of three methods of delayed breast reconstruction. Study design, patients’ preoperative problems and expectations. Scand J Plast Reconstr Hand Surg 33(2):209–216. doi:10.1080/02844319950159479

    Article  CAS  Google Scholar 

  22. Snell L, McCarthy C, Klassen A, Cano S, Rubin L, Hurley K, Montgomery GH, Cordeiro PG, Pusic A (2010) Clarifying the expectations of patients undergoing implant breast reconstruction: a qualitative study. Plast Reconstr Surg 126:1825–1830

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Abu-Nab Z, Grunfeld EA (2007) Satisfaction with outcome and attitudes towards scarring among women undergoing breast reconstructive surgery. Pat Educ Counsel 66:243–249

    Article  CAS  Google Scholar 

  24. Clifford E (1979) The reconstruction experience: the search for restitution. In: Georgiade NG (ed) Breast reconstruction following mastectomy. CV Mosby, St Louis, pp 22–34

    Google Scholar 

  25. Contant CME, van Wersch AMEA, Wiggers T, Wai RTJ, van Geel AN (2000) Motivations, satisfaction and information of immediate breast reconstruction following mastectomy. Patient Educ Counsel 40:201–208

    Article  CAS  Google Scholar 

  26. Elder EE, Brandberg Y, Björklund T, Rylander R, Lagergren J, Jurell G, Wickman M, Sandelin K (2005) Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: a prospective study. Breast 14:201–208

    Article  PubMed  Google Scholar 

  27. Fang S-Y, Balneaves LG, Shu B-C (2010) “A struggle between vanity and life”. The experience of receiving breast reconstruction in women in Taiwan. Cancer Nurs 33(5):E1–E11

    Article  PubMed  Google Scholar 

  28. Fee-Fulkerson K, Conaway MR, Winer EP, Fulkerson CC, Rimer BK, Georgiade G (1996) Factors contributing to patient satisfaction with breast reconstruction using silicone gel implants. Plast Reconstr Surg 97:1420–1426

    Article  CAS  PubMed  Google Scholar 

  29. Flitcroft K, Brennan M, Costa D, Wong A, Snook K, Spillane A (2016) An evaluation of factors affecting preference for immediate, delayed or no breast reconstruction in women with high-risk breast cancer. Psycho-Oncology 25(12):1463–1469. doi:10.1002/pon.4087

    Article  PubMed  Google Scholar 

  30. Harcourt D, Rumsey N (2004) Mastectomy patients’ decision-making for or against immediate breast reconstruction. Psycho-Oncology 13:106–115

    Article  PubMed  Google Scholar 

  31. Kraemer O, Andersen M, Siim E (1996) Breast reconstruction and tissue expansion in irradiated versus not irradiated women after mastectomy. Scand J Plast Reconstr Hand Surg 30(3):201–206. doi:10.3109/02844319609062815

    Article  CAS  Google Scholar 

  32. Lee CN, Hultman CS, Sepucha K (2010) What are patients’ goals and concerns about breast reconstruction after mastectomy? Ann Plast Surg 64(5):567–569

    CAS  PubMed  Google Scholar 

  33. Nissen MJ, Swensen KK, Kind EA (2002) Quality of life after postmastectomy breast reconstruction. Oncol Nurs Forum 29(3):547–553

    Article  PubMed  Google Scholar 

  34. Ringberg A, Tengrup I, Aspegren K, Palmer B (1999) Immediate breast reconstruction after mastectomy for cancer. Eur J Surg Oncol 25:470–476

    Article  CAS  PubMed  Google Scholar 

  35. Rosenqvist S, Sandelin K, Wickman M (1996) Patients’ psychological and cosmetic experience after immediate breast reconstruction. Eur J Surg Oncol 22:262–266

    Article  CAS  PubMed  Google Scholar 

  36. Spector D, Mayer DK, Knafl K, Pusic A (2010) Not what I expected: informational needs of women undergoing breast surgery. Plast Surg Nurs 30(2):70–74

    Article  PubMed  Google Scholar 

  37. Waljee JF, Ubel PA, Atisha DM, Hu ES, Alderman AK (2011) The choice of breast cancer surgery: can women accurately predict postoperative quality of life and disease-related stigma? Ann Surg Oncol 18:2477–2482

    Article  PubMed  Google Scholar 

  38. BREAST-Q™ Expectations Module (Pre Operative) 1.0. (2006) Memorial Sloan-Kettering Cancer Centre and The University of British Columbia

  39. Winters ZE, Afzal M, Rutherford C et al (2017) International validation of the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) for women undergoing breast reconstruction: the QLQ-BRECON23. Br J Surg (in press)

  40. Rosson GD, Shridharani SM, Magarakis M, Manahan MA, Basdag B, Gilson MM, Pusic AL (2013) Quality of life before reconstructive breast surgery: a preoperative comparison of patients with immediate, delayed, and major revision reconstruction. Microsurgery 33:253–258

    Article  PubMed  Google Scholar 

  41. Flitcroft K, Brennan M, Spillane A (2017) Making decisions about breast reconstruction: a systematic review of patient-reported factors influencing choice. Qual Life Res. doi:10.1007/s11136-017-1555-z

  42. Jeevan R, Cromwell DA, Browne JP, Caddy CM, Pereira J, Sheppard C, Greenaway K, van der Meulen JHP (2014) Findings of a national comparative audit of mastectomy and breast reconstruction surgery in England. J Plast Reconstr, Aesth Surg 67:1333–1344

    Article  Google Scholar 

  43. Festinger L (1957) A theory of cognitive dissonance. Harper and Row, New York

    Google Scholar 

  44. Waljee J, McGlinn EP, Davis Sears E, Chung KC (2014) Patient expectations and patient-reported outcomes in surgery: a systematic review. Surgery 155:799–808

    Article  PubMed  Google Scholar 

  45. Reaby LL (1998) Reasons why women who have mastectomy decide to have or not to have breast reconstruction. Plast Reconstr Surg 101:1810–1818

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia

    Kathy Flitcroft, Meagan Brennan & Andrew Spillane

  2. Northern Clinical School, University of Sydney, Sydney, NSW, 2006, Australia

    Kathy Flitcroft, Meagan Brennan & Andrew Spillane

Authors
  1. Kathy Flitcroft
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Meagan Brennan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew Spillane
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kathy Flitcroft.

Electronic supplementary material

ESM 1

(DOCX 15 kb)

ESM 2

(DOCX 17.2 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Flitcroft, K., Brennan, M. & Spillane, A. Women’s expectations of breast reconstruction following mastectomy for breast cancer: a systematic review. Support Care Cancer 25, 2631–2661 (2017). https://doi.org/10.1007/s00520-017-3712-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-017-3712-x

Keywords

Search

Navigation