RESEARCH PAPER
Motives for the choice of not undergoing breast reconstruction
More details
Hide details
1
Chair of Oncology and Environmental Care, Faculty of Health Sciences, Medical University of Lublin, Poland
2
Chair of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
Corresponding author
Beata Dobrowolska
Chair of Development in Nursing, Faculty of Health Sciences, Medical University, Staszica 4–6, 20-081 Lublin, Poland
J Pre Clin Clin Res. 2016;10(1):39-44
KEYWORDS
ABSTRACT
Introduction and objective:
Currently, most women with less advanced breast cancer are offered operations with breast conserving treatment; however, if it is necessary to completely remove the breast, the patients may benefit from free breast reconstruction. The aim of the study was to determine the motives for breast reconstruction after mastectomy or decisive reasons for rejecting this treatment.
Material and Methods:
The study included 241 women hospitalized in Polish oncological hospitals who were divided into two groups: 55.19% (n=133) were women after mastectomy; 44.81% (n=108) after breast reconstruction. Quantitative approach with the use of survey method was utilised.
Results:
Women who wished to undergo breast reconstruction were generallyy younger, better educated and more often professionally active. For women who wished to undergo breast reconstruction, the most important aspect was the willingness to improve their body image, their mental well-being, the inconvenience connected with wearing the prosthesis, better sexual relations with husband/partner, and the possibility of exposing the neckline without discomfort. The strongest correlation was found between women’s young age and their functioning in a relationship. Women after mastectomy, who decided not to undergo a breast reconstruction, were afraid of another operation, suffering, and they believed that there were more important issues.
Conclusions:
The study revealed a relationship between the lack of knowledge, in which hospital breast reconstruction procedure can be performed and the lack of motivation for undergoing the procedure. Women who have had knowledge of the possibility of a free breast reconstruction were younger, better educated and more often lived in the city.
REFERENCES (30)
1.
Lee CN, Belkora J, Chang Y, Moy B, Partridge A, Sepucha K. Are patients making high-quality decisions about breast reconstruction after mastectomy? Plast Reconstr Surg. Jan 2011; 127(1): 18–26.
2.
Goldwyn RM. Vincenz Czerny and the beginnings of breast reconstruction. Plast Reconstr. Surg. 1978; 61: 673–680.
3.
Gilles HD, Millard DR. Principles and art of plastic surgery. Boston 1957, Little Brown, pp. 297- 300.
4.
Lewandowska H. Sposoby na nową pierś. Sprawy Nauki. Biuletyn Ministra Nauki i Szkolnictwa Wyższego. 2005;4:109–111 (in Polish).
5.
Fersis N, Hoenig A, Rlakis K. Skin – sparing mastectomy and immediate breast reconstruction incidence of recurrence in patients with invasive breast cancer. Breast 2004; 139: 488- 493.
6.
Simmons RM, Hollenbeck ST, Latrenta GS. Two – year follow – up of areola sparing mastectomy with immediate reconstruction. Am J Surg. 2004; 188: 403–406.
7.
Towpik E. Rak piersi. Przegląd Piśmiennictwa Chirurgicznego 2004; 8: 82–88. (in Polish).
8.
Crove JP, Kim JA, Yetman R, Banbury J, Patrick RJ, Baynes D. Nipple – sparing mastectomy: technique and results of 54 procedures. Arch Surg. 2004; 114:1551–1552.
9.
Magarey C J. Aspects of the psychological management of breast cancer. The Med J Australia. 1988; 148: 239–242.
10.
Wellisch DK, Schain WS, Noone R B, Little J W. III Psychosocial correlates of immediate versus delayed reconstruction of the breast. Plast Reconstr Surg. 1985; 76:713–718.
11.
Stevens L A, McGrath M H, Druss R G, Kister S J, Gump F E, Forde K A. The psychological impact of immediate breast reconstruction for women with early breast cancer. Plast Reconstr Surg. 1984; 73: 619–628.
12.
Brandberg Y, Malm M, Bloquist L. A prospective and randomized study, “SEVEA” comparing effects of three methods for delayed breast reconstruction on quality of life, patient – defined problems area of life and cosmetic result. Plast Reconstr Surg. 2000; 105:66–74.
13.
Mac D. Choices following mastectomy. Practice Nurse 2006; 22:9:1583–1592.
14.
Towpik E, Mazur S, Witwicki T, Tchórzewska H. et. al. Operacje odtwórcze piersi z użyciem ekspandera/protezy Beckera. Nowotwory 1999; 4, (49): 425–427. (in Polish).
15.
Hack TF. The communications goals and needs of cancer patients: a review. Psycho-Oncology 2005;14: 831–845.
16.
Nano TM, Gill PG, Kolias J, et al. Qualitative assessment of breast reconstruction in a specialist breast unit. ANZ. J Surg. 2005; 75:445–453.
17.
Harcourt DM, Rumsey N, Ambler NR, et al. The psychological effect of mastectomy with and without breast reconstruction. Plastic Reconstr Surg. 2002; 111(3): 1060–1068.
18.
Fedorczuk A. Odzyskana kobiecość. Nowotwór. Newsweek Polska. 2006; (9): 89–91 (in Polish).
19.
Heller L, Miller MJ. Patient Education and Decision Making in Breast Reconstruction. Semin Plast Surg. May 2004; 18(2): 139–147.
20.
Morrow M, Mujahid M, Lantz PM, et al. Correlates of breast reconstruction. Results of population based study. Cancer 2005; 1(104): 2340–2346.
21.
Al- Ghazal SK, Fallowfield L, Blamey RW. The psychological impact of immediate rather than delayed breast reconstruction. Eur J Surg Oncol. 2000; 26: 17–19.
22.
Gul GP, Tan SM, Falakou EC, et al. Immediate breast reconstruction using biodimensional anatomical permanent expander implants: a prospective analysis of outcome and patient satisfaction. Plast Reconstr Surg. 2003; 111: 125–138.
23.
Fentiman S, Hamed H. Breast reconstruction. J Clin Pract. 2006; 60(4): 471–474.
24.
Meretoja E, Souminen E. Demand for plastic surgical operations after primary breast cancer. Scandinavian J Surg. 2005; 94: 211–215.
25.
Harcourt D, Rumsey N. Breast reconstruction: the psychological implications and reasoning behind decision made by women undergoing mastectomy following diagnosis of breast cancer. J Adv Nursing. 2001; 35(4): 477–487.
26.
Morrow M, Scott SK, Menck HR, et al. Factors influencing the use of breast reconstruction postmastectomy: A National Cancer Database study. J Am Coll Surg. 2001; 92:1–8.
27.
Fallbjörk U, Karlsson S, Salander P, Rasmussen BH. Differences between women who have and have not undergone breast reconstruction after mastectomy due to breast cancer. Acta Oncol. 2010; 49(2): 174–179. doi: 10.3109/02841860903490069.
28.
Callaghan CJ, Couto E, Kerin MJ, Rainsbury RM, George WD. Purushotham AD. Breast reconstruction in United Kingdom and Ireland. Br J Surg. 2002; 89: 335–340.
29.
Panieri E, Lazarus D, Dent DM, Hudson DA, et al. A study of the patient factors affecting reconstruction after mastectomy for breast carcinoma. Am Surg. 2003; 69: 95–97.
30.
Héquet D, Zarca K, Dolbeaut S, Coutuaraud B, et al. Reasons of not having breast reconstruction: a historical cohort of 1937 breast cancer patients undergoing mastectomy. Springer Plus. 2013; 2: 325. doi:10.1186/2193-1801-2-325.