Psychological profile of women seeking breast reconstruction and quality of life assessment after surgery

Abstract

Even though the number of women seeking reconstruction after mastectomy has risen during the last decade from 10% to 30%, this percentage remains low. Research suggests that quality of life improves after breast reconstruction. This raises the question as to why reconstructive surgery is not performed more often. Could it be that only those patients asking for reconstructive surgery experience an improved quality of life? And how can this group be characterized? In this study, the psychological profile of women seeking breast reconstruction was evaluated and, compared to that for women who do not have the wish for breast reconstruction. In addition, quality of life was related to the psychological profile in both groups. Sixty-seven patients who had undergone a breast reconstruction over a 10-year period were included in the study. Psychological evaluation consisted of three standardized self-administered questionnaires: the Eysenck’s Personality Questionnaire, the Profile of Mood States and the Self Consciousness Scale. Quality of life was assessed using the Nottingham Health Profile (I and II) and the EQ-5D. A matched group of 155 women who had undergone a mastectomy without reconstruction were used as a control group. The psychological profile of the two groups was found to be significantly different. Women in the reconstruction group were more extravert, more self-conscious and also sexually more self-conscious (all: P<0.05) in comparison to the patients in the non-reconstruction group. In addition, women in the reconstruction group were (socially) more active, more talkative, more animated, sought contact easier, put themselves forward more often and took the initiative more often. In the quality of life surveys, only marginal differences were found between the groups. The quality of life was not found to be significantly different in the two groups of patients. However, there is a significant difference in the psychological profile of the women. This explains why on the one hand the percentage of breast reconstruction is relatively low, while on the other hand it has been shown that quality of life improves after breast reconstruction.