Annals of Oncology Advance Access published online on April 4, 2008
Annals of Oncology, doi:10.1093/annonc/mdn153
Satisfaction with and psychological impact of immediate and deferred breast reconstruction
1 Servicio de Cirugía Plástica del Hospital Universitario La Paz, Madrid
2 Unidad de Evaluación de Tecnologías Sanitarias, Agencia Laín Entralgo, Madrid
3 Área de Investigación y Estudios sanitarios, Agencia Laín Entralgo, Madrid
4 Servicio de Ginecología del Hospital Universitario La Paz, Madrid, Spain
* Correspondence to: M. Reza, Unidad de Evaluación de Tecnologías Sanitarias, Agencia Laín Entralgo, C/ Gran Vía 27, 7a, 28013 Madrid, Spain. Tel: +34-91-308-9473; Fax: +34-91-308-9463; E-mail: mercedes.reza{at}salud.madrid.org
Background: The present work assesses the effect of immediate breast reconstruction (IBR), deferred breast reconstruction (DBR), and no breast reconstruction on the psychological impact.
Patients and methods: Standard questionnaires were used to determine the psychological impact suffered by patients who underwent IBR, DBR and no reconstruction, their degree of satisfaction with the results achieved, and their postprocedure opinions regarding reconstruction options.
Results: A total of 526 women underwent mastectomy. The response rate to the questionnaires was 71.67%. A significantly greater proportion of the women who underwent no reconstruction suffered psychological problems than those who underwent reconstruction of some type (P = 0.01). Some 94.77% of the women who underwent IBR maintained a postprocedure preference for this option; in contrast, some 87.27% of the DBR and 56.14% of the no-reconstruction patients declared a postprocedure preference for IBR. In all, 63.49% of the women who underwent reconstruction were moderately very satisfied with the aesthetic results achieved, while only 22.80% of the no-reconstruction patients declared such satisfaction (P = 0.0001).
Conclusions: The women who underwent no breast reconstruction suffered more emotional problems than those who underwent a reconstruction procedure. In general, all groups reported a postprocedure preference for IBR in their questionnaire answers. The aesthetic results achieved by IBR seem to be those best accepted.
breast neoplasm, breast/surgery, mammaplasty, mastectomy, patient satisfaction, plastic surgery
Received for publication February 20, 2008. Revision received March 7, 2008. Accepted for publication March 7, 2008.