J Breast Cancer.  2011 Feb;14(Suppl 1):S70-S76. 10.4048/jbc.2011.14.S.S70.

Survey of Psychosocial Problems Facing Breast Cancer Survivors after Undergoing a Mastectomy and Their Awareness of Breast Reconstruction

Affiliations
  • 1Breast Care Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. brcakorea@gmail.com
  • 2Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 3Department of Surgery, Korea Cancer Center Hospital, Seoul, Korea.
  • 4Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
  • 5Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
  • 6Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 7Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea.
  • 8Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
  • 9Center for Breast Cancer, National Cancer Center, Goyang, Korea.
  • 10Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
Breast reconstruction in patients who have undergone a mastectomy is performed less frequently in Korea than in Western countries. The aim of this study was to investigate the psychosocial problems related to a mastectomy and awareness of reconstruction after a mastectomy in breast cancer survivors.
METHODS
From March to April 2010, 252 patients who underwent a mastectomy were recruited for this survey. The questionnaire included sociodemographic characteristics of patients, psychosocial problems related to mastectomy, and reasons not to receive breast reconstruction.
RESULTS
Patients had difficulty going to a public bath (70.3%) or going to a swimming pool or the beach (74.6%). More than half of patients answered that their physical activity had decreased due to persistent shoulder or arm pain after the mastectomy. The most common psychological problem that patients experienced was distress over the loss of charm as a woman (66.8%), followed by considering themselves disabled (62.0%), and worries about recurrence (59.4%). The most common reason not to receive a breast reconstruction was the high cost of the operation (59.4%), followed by anxiety about complications (46.7%). Only 16.2% of patients reported that they did not receive enough information about reconstruction from their doctor. Of 229 patients, 43.7% would consider undergoing breast reconstruction in the future.
CONCLUSION
Breast cancer survivors who underwent a mastectomy suffered from various psychosocial problems, and high cost was a major reason for not undergoing breast reconstruction. Broader health insurance coverage should be provided for breast reconstruction in breast cancer survivors.

Keyword

Breast Neoplasms; Mammaplasty; Mastectomy

MeSH Terms

Female
Humans
Breast Neoplasms

Figure

  • Figure 1 Social problems in patients who underwent mastectomy for breast cancer.

  • Figure 2 Psychological problems in patients who underwent mastectomy for breast cancer.


Reference

1. Schover LR. Sexuality and body image in younger women with breast cancer. J Natl Cancer Inst Monogr. 1994. 177–182.
2. Park EJ, Jeon YW, Han SI, Oh SJ. A preliminary study on the quality of life for patients who had breast cancer operations. J Korean Breast Cancer Soc. 2004. 7:299–305.
Article
3. Kim LS, Son HG. Comparison of psychiatric symptoms between total mastectomy and breast conserving surgery in breast cancer patients. J Korean Surg Soc. 2001. 60:237–242.
4. Kim SW, Han W, Jeong J, Park HK, Noh WC, Lee ES, et al. The policy proposal for effective prevention and management of breast cancer. J Breast Cancer. 2006. 9:270–292.
Article
5. The Korean Breast Cancer Society. Nationwide Korean breast cancer data of 2004 using breast cancer registration program. J Breast Cancer. 2006. 9:151–161.
6. Desch CE, Penberthy LT, Hillner BE, McDonald MK, Smith TJ, Pozez AL, et al. A sociodemographic and economic comparison of breast reconstruction, mastectomy, and conservative surgery. Surgery. 1999. 125:441–447.
Article
7. Hall SE, Holman CD. Inequalities in breast cancer reconstructive surgery according to social and locational status in Western Australia. Eur J Surg Oncol. 2003. 29:519–525.
Article
8. Bae YC, Kim SH, Kim JH, Bae YT. A study on the perception of breast reconstruction in mastectomized patients and general population in Korea. J Korean Soc Plast Reconstr Surg. 1997. 24:1062–1076.
9. Morrow M, Mujahid M, Lantz PM, Janz NK, Fagerlin A, Schwartz K, et al. Correlates of breast reconstruction: results from a population-based study. Cancer. 2005. 104:2340–2346.
10. Breast cancer facts & figures. Korean Breast Cancer Society. Accessed August 30th, 2010. http://www.kbcs.or.kr/journal/file/2006_2008_Breast_Cancer_Facts_and_Figures_updated.pdf.
11. Coburn N, Fulton J, Pearlman DN, Law C, DiPaolo B, Cady B. Treatment variation by insurance status for breast cancer patients. Breast J. 2008. 14:128–134.
Article
12. Rosson GD, Singh NK, Ahuja N, Jacobs LK, Chang DC. Multilevel analysis of the impact of community vs patient factors on access to immediate breast reconstruction following mastectomy in Maryland. Arch Surg. 2008. 143:1076–1081.
Article
13. Christian CK, Niland J, Edge SB, Ottesen RA, Hughes ME, Theriault R, et al. A multi-institutional analysis of the socioeconomic determinants of breast reconstruction: a study of the National Comprehensive Cancer Network. Ann Surg. 2006. 243:241–249.
Article
14. Horner-Taylor C. The Breast Reconstruction Advocacy Project: one woman can make a difference. Am J Surg. 1998. 175:85–86.
Article
15. Alderman AK, Wei Y, Birkmeyer JD. Use of breast reconstruction after mastectomy following the Women's Health and Cancer Rights Act. JAMA. 2006. 295:387–388.
Article
16. Lee SW, Kim HS, Jeong JH, Seul JH, Lee SJ. A study on the perception of breast reconstruction in breast reconstructed patients after mastectomy in Korea. J Korean Soc Plast Reconstr Surg. 2000. 27:463–468.
17. World Health Organization. ICF: International Classification of Functioning, Disability and Health. 2001. Geneva: World Health Organization.
18. Fernández-Delgado J, López-Pedraza MJ, Blasco JA, Andradas-Aragones E, Sánchez-Méndez JI, Sordo-Miralles G, et al. Satisfaction with and psychological impact of immediate and deferred breast reconstruction. Ann Oncol. 2008. 19:1430–1434.
Article
19. Kang HJ, Kim SW, Noh DY, Youn YK, Oh SK, Choe KJ, et al. Immediate breast reconstruction after a mastectomy for breast cancer. J Korean Surg Soc. 2000. 59:584–589.
20. Rowland JH, Desmond KA, Meyerowitz BE, Belin TR, Wyatt GE, Ganz PA. Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J Natl Cancer Inst. 2000. 92:1422–1429.
Article
21. Lee C, Sunu C, Pignone M. Patient-reported outcomes of breast reconstruction after mastectomy: a systematic review. J Am Coll Surg. 2009. 209:123–133.
Article
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