Breast cancer in young women

Abstract

Breast surgery in young women is associated with a significant impact on the patient’s health-related quality of life due to changes in body image and sexuality. These perceptions are being increasingly considered as integral to understanding health outcomes. Of the available surgical techniques, mastectomy is associated with the highest psychosocial morbidity, and breast-conserving surgery with the least. If breast-conserving surgery is not an option, breast reconstruction may help restore the patient’s body image, psychological well-being and expectations after mastectomy. Autologous and prosthetic breast reconstructions are the two main techniques used, yielding comparable postoperative outcomes. Timing of breast reconstruction largely depends on the need for adjuvant radiotherapy, as it significantly increases the risk of complications. Besides surgical sequelae, adverse events of adjuvant chemo- and/or endocrine therapy, which vary according to the type of systemic treatment, add significantly to the psychological and physical impact of a diagnosis of breast cancer. Completion of cancer treatment can also be extraordinarily stressful because of the fear of recurrence and the lingering side effects of systemic therapy, such as fatigue, alopecia, and menopausal symptoms.