The physical and psychological effects of breast reconstruction in breast cancer patients : a retrospective quantitative analysis between 2009 and 2011at Mater Dei Hospital, Malta

Abstract

Breast cancer is a devastating disease afflicting many women. The aim of this retrospective review was to assess the physical and psychological effects of patients who underwent breast reconstruction after breast cancer surgery. Methods: Clearance from the patients’ consultants, data protection officer and medical ethics committee was sought and granted. A participation letter was sent to 67 eligible patients who had reconstructive breast surgery between 2009 and 2011. Forty-two (63%) patients agreed to participate. These patients had a short personal interview during which two questionnaires (SF-36v2 health survey and one on the physical aspects) were completed. Results: The patients’ mean age was 53.9 years (range 31-75). Reconstructive breast surgery using implant-only was performed in twenty-eight (66.7%) cases. Twenty-three (54.8%) of the forty-two patients had complications, with 1.35 complications/per person affected. The complication rate did not differ significantly amongst the different reconstruction groups (p=0.196). Patients who underwent autologous and oncoplastic reconstructive procedures scored significantly higher satisfaction scores than the prosthesis and prosthesis/autologous group (p= 0.01). Whether or not the reconstruction was immediate or delayed or the patients had complications, did not have statistically significant effects on the patients’ health domain scores (p>0.05). The difference of two proportions between the sample studied and the norm showed that the sample studied had a statistically significant higher depression risk than the norm population (p=0.0154). Major conclusions: Complication rates were comparable amongst the different reconstruction techniques. A higher than normal depression risk was found in the sample studied and therefore improvement of the support services given to patients is recommended.