Quality of life evaluation and decision-making after mastectomy for breast reconstruction of breast cancer patients.

Abstract

Abstract Abstract #4098 Background:
 What is the level of information and the information needs of Breast Cancer patients after mastectomy regarding secondary breast reconstruction. Evaluation of the impact of a mastectomy regarding Quality of Life, satisfaction with the surgical result and personal job situation as well as the influence of a partnership according to the Quality of Life parameters.
 Material and Methods:
 From January 2000 until May 2003 a number of 282 women suffering from Breast Cancer underwent a mastectomy for various indications. During the routinely Breast Cancer follow-up Quality of Life was assessed using the EORTC QLQ-C30 questionnaire and the breast cancer specific module BR23 in patients at least one year after the mastectomy. 149 (52.8%) patients were excluded for the following reasons: Local recurrence (5%), pT4 stage cancer (3.5%), performed secondary breast reconstruction (22%) and an age of over 75 years (22.3%). 3.5% of the remaining 133 (47.2%) patients died, 3.5% moved with unknown address and 7.1% refused the questionnaire. All together 86 (30.5%) questionnaires could be evaluated.
 Results:
 93% of the patients were aware of the possibility to have a breast reconstruction.
 Patients satisfied with the results of the surgical procedure comprised a higher level of content with their body image and reported higher overall Quality of Life compare to less satisfied patients.
 Patients with a good body image had significantly less problems showing themselves nude to their partner (p < .0001) and accepted physical touch by them in the breast region significantly more frequently (p < .004) compared to those with a poor body image.
 16% of the patients underwent secondary breast reconstruction between the last follow-up and the start of the questionnaire. 8% of the patients made the decision for breast reconstruction after filling in the questionnaire due to more information.
 Discussion:
 Although the majority of patients were well informed about the modalities of breast reconstruction, an additional 8% of the patients made a decision for breast reconstruction. In conclusion, due to our observation, additional information to patients about the possibility of secondary breast reconstruction even after one or more years, can lead to an unexpected high number of secondary breast reconstruction. We believe that this further information should be integrated into routine clinical practice. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4098.