Psychological Factors Predict Patient Satisfaction with Postmastectomy Breast Reconstruction

Abstract

This prospective study examined the contribution of psychological factors to the prediction of patient satisfaction with postmastectomy breast reconstruction surgery. Women presenting for breast reconstruction were administered presurgical psychological inventories. Measures of affective distress, depressive symptoms, anxiety, somatization, and somatic preoccupation were obtained from standardized inventories. At 1-year (n = 295) and 2-year (n = 205) follow-up, subjects completed ratings of their satisfaction with both the general and aesthetic results of surgery. After controlling for sociodemographic variables and both surgical procedure type and timing, multiple linear regression analyses indicated that at 1-year follow-up preoperative measures of affective distress, depression, somatization, and somatic anxiety predicted less general satisfaction with surgical outcome, while presurgical levels of affective distress, depression, anxiety, somatization, and somatic anxiety predicted decreased aesthetic satisfaction. At 2-year follow-up, only preoperative affective distress retained a significant association with lowered general satisfaction with reconstructive surgery. In addition, at 2-year reassessment, aesthetic quality of surgical outcome was inversely related to all the presurgical psychological variables. Affective distress and somatic preoccupation negatively influence patient satisfaction with both aesthetic and general outcomes associated with postmastectomy breast reconstruction. Presurgical psychological screening and counseling of selected women who are being considered for breast reconstruction may be advisable to enhance patient satisfaction with reconstructive surgery.