October 10, 2016
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Immediate autologous breast reconstruction may reduce poor body image, improve QOL

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Patients undergoing immediate autologous breast reconstruction showed a shorter period of psychosocial distress, poor body image, and decreased sexuality compared with patients undergoing delayed reconstruction, according to study data published in Plastic and Reconstructive Surgery.

Researchers recruited 106 women aged 18 years or older who were diagnosed with breast cancer and undergoing mastectomy from June 1, 2009, to December 21, 2010. The patients were given four questionnaires to complete before surgery and at 6, 12 and 18 months after surgery. The questionnaires were completed by 75% of patients at 6 months, 82% at 12 months, and 69% at 18 months.

The questionnaires included the Hospital Anxiety and Depression Scale, the Body Image Scale, the Sexuality Scale and the BREAST-Q measure.

Results of the surveys showed that patients in the delayed group showed significantly worse perception of body image, sexuality and health-related quality of life compared to the immediate group before reconstruction.

The results of the surveys after reconstruction, however, showed successful improvements in all quality-of-life domains for both groups at comparable levels.

“It may provide reassurance to delayed breast reconstruction patients that body image and appearance concerns are likely restored relatively quickly after surgery, and intimacy and sexual well-being, although slower to normalize, will reach levels comparable to those of immediate breast reconstruction patients by 12 to 18 months,” Toni Zhong, MD, MHS, and colleagues wrote.

The researchers advise, according to these results, that patients who are candidates for immediate breast reconstruction and are strongly motivated should be put forward for that procedure and that patients needing delayed reconstruction should be expedited to minimize the duration of psychosocial distress. – by Talitha Bennett

Disclosure: Zhong reports he holds a New Investigator Award (2015-2020) from the Canadian Institutes of Health Research. Please see the full study for a complete list of all other authors' relevant financial disclosures.