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. 2017 Feb;139(2):267-275.
doi: 10.1097/PRS.0000000000002943.

Why Some Mastectomy Patients Opt to Undergo Delayed Breast Reconstruction: Results of a Long-Term Prospective Study

Kelly A Metcalfe  1   2 , John Semple  1   2 , May-Lynn Quan  1   2 , Claire Holloway  1   2 , Frances Wright  1   2 , Steven Narod  1   2 , Stefan Hofer  1   2 , Shaghayegh Bagher  1   2 , Toni Zhong  1   2
Affiliations

Why Some Mastectomy Patients Opt to Undergo Delayed Breast Reconstruction: Results of a Long-Term Prospective Study

Kelly A Metcalfe et al. Plast Reconstr Surg. 2017 Feb.

Abstract

Background: Delayed breast reconstruction is an option for women who have undergone mastectomy; however, uptake is low. The purpose of this study was to identify premastectomy and postmastectomy demographic, clinical, and psychosocial predictors of uptake of delayed breast reconstruction in the long-term survivorship period.

Methods: This was a prospective longitudinal survey study of mastectomy patients in which a repeated measures design was used to evaluate uptake of delayed breast reconstruction. Demographic, clinical, and psychosocial variables were collected before mastectomy and 1 year after mastectomy. Information regarding uptake of delayed breast reconstruction was collected at approximately 6 years after mastectomy. A predictive model was designed using a multivariate logistic regression model and Akiake information criterion stepwise algorithm.

Results: Ninety-six mastectomy patients were followed from before mastectomy to 75.2 months after mastectomy, and 35 women (36.5 percent) underwent delayed breast reconstruction. Women who elected for delayed breast reconstruction experienced worsening of body concerns from before mastectomy to 1 year after mastectomy, compared with women who did not elect to undergo delayed breast reconstruction (p = 0.03). Mean scores for psychological distress were significantly worse both before mastectomy and 1 year after mastectomy in women who went on to undergo delayed breast reconstruction compared with those who did not undergo delayed breast reconstruction (p = 0.034 and p = 0.022, respectively). A predictive model for the uptake of delayed breast reconstruction was developed using demographic, clinical, and psychosocial characteristics. The area under the receiver operating characteristic curve was 85 percent, indicating good precision.

Conclusions: Women who are experiencing higher levels of distress, anxiety, and body concerns both before and after mastectomy appear to be significantly likely to select delayed breast reconstruction. This may have implications for postreconstruction satisfaction and psychosocial functioning.

Clinical question/level of evidence: Risk, III.

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References

    1. American Cancer Society. Cancer facts and figures 2015. Available at: http://www.cancer.org/acs/groups/content/@editorial/documents/document/a.... Accessed March 13, 2016.
    1. Kummerow KL, Du L, Penson DF, Shyr Y, Hooks MA. Nationwide trends in mastectomy for early-stage breast cancer. JAMA Surg. 2015;150:916.
    1. Tuttle TM, Habermann EB, Grund EH, Morris TJ, Virnig BA. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: A trend toward more aggressive surgical treatment. J Clin Oncol. 2007;25:52035209.
    1. Harcourt D, Rumsey N. Psychological aspects of breast reconstruction: A review of the literature. J Adv Nurs. 2001;35:477487.
    1. Noone RB, Frazier TG, Noone GC, Blanchet NP, Murphy JB, Rose D. Recurrence of breast carcinoma following immediate reconstruction: A 13-year review. Plast Reconstr Surg. 1994;93:96106; discussion 107.