Post-mastectomy Women Research Articles

P-2240. Metabolomic Approaches to Detect Implant-Associated Infections in Post-Mastectomy Women

Abstract Background This year, approximately 54,000 women with breast cancer will undergo mastectomy followed by implant-based immediate breast reconstruction. This procedure has high infection rates of up to 20% and a diverse microbiology of infection including both gram-positive and gram-negative organisms. Culture-based diagnostic methods after these procedures suffer from poor sensitivity due to antibiotic administration prior to cultures, infection with fastidious organisms, and sequestration of bacteria in implant-associated biofilms. Culture-independent diagnostic methods may serve as an alternative for fast, more accurate diagnosis of these infections. Methods Women undergoing implant-based immediate breast reconstruction were recruited. Seroma fluid was collected from the breast pocket at the time of implant removal due to infectious complications, non-infectious wound complications, or at the time of second stage reconstruction. Samples were analyzed using untargeted liquid chromatography/mass spectrometry (LCMS). Differential Compositional Variation Machine Learning (DiCoVarML) was used to discover metabolic features to differentiate infection status in this population. Results 80 seroma fluid samples taken at time of implant removal were analyzed. Of these, 37 samples were collected at the time of implant removal due to infection, 7 for non-infectious complications, and 36 were collected at the time of second stage reconstruction. After LCMS, 3663 high-quality features were detected in at least ten samples. Features useful in distinguishing infection status were selected using DiCoVarML. Predictive models were able to reliably distinguish infection status, with an area under the receiver operating characteristic curve of ∼0.85. Many features positively correlated with infection are structurally similar to peptides. Conclusion Metabolite-based diagnostic methods appear to be promising tools to diagnose infection in immediate breast reconstruction. Features associated with infection may represent small immune proteins/peptides or degradation products from host or pathogen proteases. Further analysis is ongoing to fully identify metabolites associated with infection. Disclosures Margaret A A. Olsen, PhD, MPH, Pfizer: Advisor/Consultant|Rebyota: Advisor/Consultant

Robot-Assisted Versus Conventional Harvesting of DIEP and Latissimus Dorsi Flaps for Breast Reconstruction in Post-Mastectomy Women: A Systematic Review and Meta-Analysis

Background/Objectives: Robotic breast reconstruction is an innovative surgical technique that integrates robotic technology into breast reconstruction procedures, offering several advantages over conventional approaches. These benefits include enhanced visualization, increased surgical dexterity, and superior cosmetic outcomes. This study aims to comprehensively compare robotic-assisted and conventional breast reconstruction approaches in terms of complication profiles and operation-related measurements. Methods: A comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, Google Scholar, CENTRAL, and VHL from inception to October 2024 to identify relevant studies. Risk ratios for the following complications were calculated between the groups: donor site seroma, hematoma, infection, and unplanned reoperation. Mean differences were also calculated for the duration of surgery, length of postoperative hospital stays, and opioid use. Results: A meta-analysis was performed on 9 studies including a total of 1094 patients. No significant differences were found between the groups in the risk ratios for reoperation, seroma formation, delayed healing, infections, and hematomas. Similarly, there were no significant differences in postoperative opioid use. The duration of surgery was longer in the robot-assisted reconstruction group, whereas the duration of hospital stay was shorter compared to the conventional group. Meta-regression analysis for the duration of surgery model showed that none of the moderators had a statistically significant effect on this outcome. ROBINS-I assessment indicated that all the included studies had a serious risk of bias. Conclusions: Our results suggest that using a robot-assisted approach is associated with a shorter duration of hospital stay and a longer duration of surgery.

Brassiere-Wearing Practices and Issues among Post-mastectomy Women: A Systematic Review.

This systematic review was carried out to appraise the evidence regarding the brassiere-wearing practices and problems faced by breast cancer survivors. An electronic search was carried out across eight databases such as PubMed, Scopus, Web of Science, Science Direct, Google Scholar, Embase, CINAHL and ProQuest. Two researchers independently screened the studies for their eligibility and study quality. A total of 309 studies were assessed for eligibility. After conflict resolution by the third reviewer, five studies were selected for systematic review. All study outcomes in terms of the pattern of brassieres/prostheses, issues and challenges faced by women post-mastectomy were reviewed. It was observed that very few studies were published from various countries all over the world. All the studies were of descriptive type except one, which adopted a prospective randomised crossover design. The brassieres or prostheses, the survivors preferred were homemade made of cotton, cloth, wool, rice, sponge or commercially silicon-made. Weight of the brassiere/prostheses, discomfort, displacement while doing activities of daily living and impaired body image were common issues identified, while the unavailability of size or fit of the brassieres or requirement of alteration in clothes to meet clothing styles were common challenges faced by post-mastectomy women. It was concluded that the post- mastectomy used varied types of brassieres or prostheses with various associated issues and challenges.

Degree of acceptance of the disease and quality of life in women after mastectomy: a preliminary study

Background: The sudden change of life situation caused by a cancer diagnosis and mastectomy disturbs the psychosomatic balance and the functioning of a woman's previous life and leads to a reduced quality of life. Many women adapt to their new situation, but a very large group cannot adapt and cope with their illness.Aim of the study: Evaluation of disease acceptance and quality of life (QoL) in women after mastectomy.Material and methods: A total of 171 post-mastectomy women were studied. The study was conducted by means of a diagnostic survey using a questionnaire technique. The Acceptance of Illness Scale (AIS) and the Quality of Life Assessment Questionnaire (WHOQOL-BREF) were used.Results: The mean disease acceptability was 25.68 7.978. A group of 42.69% (72/171) had moderate disease acceptability, 32.75% (56/171) had high disease acceptability and 20.47% (35/171) had low disease acceptability. 4.09% (8/171) of the women had no acceptance of the disease. The mean value for the perception of QoL was 3.65 0.71. The best values were obtained for QoL in the psychological domain (14.1 3.1) and the worst in the physical domain (13.0; 2.7). Place of residence (p = 0.081) and education level (p = 0.196) did not significantly influence the acceptance of illness. Women living in village areas had a lower quality of life in the environmental domain (p = 0.036) than those living in the city. The absence of complications after mastectomy determined a higher level of QoL in the physical (p < 0.001), psychological (p = 0.029) and environmental (p = 0.010) domains, as well as greater acceptance of the disease (p = 0.001). Disease acceptance was associated with an improvement in the quality of life of women who had undergone a mastectomy, across all domains. Conclusions: It is important to increase interventions to support the adjustment process of women after mastectomy, as acceptance of the disease improves the QoL of these women.

ASSESMENT OF EMOTIONAL FUNCTIONING AND SELF-PERCEPTION IN POST MASTECTOMY WOMEN.

Breast cancer is the most common cancer in women which affects them emotionally and psychologically. The aim of this research was to examine emotional functioning and self-perception in post mastectomy women. This cross-sectional single-center study included 101 women with breast cancer one month and one year after mastectomy. It was conducted using anonymous questionnaires developed by the European Organization for Research and Treatment of Cancer (EORTC): EORTC Quality of Life questionnaire (QLO) - C 30 (version 3), questionnaire with breast cancer module EORTC QLQ BR-23 and a sociodemographic questionnaire. Compared to results one month after mastectomy, in women one year after mastectomy there was significantly less tension (Mann-Whitney U test, p=0.011) and emotional irritability (Mann- Whitney U test, p=0.013), also the memory problems declined (Mann-Whitney U test, p=0.008). Discomfort with hair loss affected all parameters except concentration problems. The participants felt less physical attractive (p=0.647), were worried (p=0.645) and less feminine due to illness (p=0.638). A year after surgery there was no connection between anxiety and observed parameters. Breast cancer affects emotional functioning and self-perception of women especially in early postoperative period and during cancer treatment. A year after surgery there was no more connection between anxiety and hair loss discomfort. Patients need medical, social and psychological support during and after breast cancer treatment.

The Effect of Counseling on Body Image and Loneliness among Post-mastectomy Women; An Interventional Study

The Effect of Counseling on Body Image and Loneliness among Post-mastectomy Women; An Interventional Study

Effects of Music-based Rhythmic Exercise Program of Upper and Lower Extremities on Lymphedema, Muscle Strength, and Physical Function in Post-mastectomy Women

Effects of Music-based Rhythmic Exercise Program of Upper and Lower Extremities on Lymphedema, Muscle Strength, and Physical Function in Post-mastectomy Women

The Lived Experience of Ethiopian Women After Mastectomy due to Breast Cancer: A Qualitative Study.

The impact of breast absence on women's lived experiences is not well studied in Sub-Saharan Africa particularly in Ethiopia, with implications for service design. This study aimed to explore the lived experiences of Ethiopian women after mastectomy due to breast cancer. A qualitative study approach was used to explore the experiences of women who underwent a mastectomy at the oncology unit of Tikur Anbessa Specialized Hospital. Before the commencement of the study, consent was obtained from each respondent. An in-depth interview was conducted with twelve post-mastectomy women using a semi-structured interview guide. Audio-recorded data were transcribed verbatim and translated into English. Data were coded, sorted, and themes were developed manually based on the thematic analysis. Five themes illustrating the impact on the women's life after mastectomy were identified and categorized into (1) Perceived alteration in physical and psychosocial aspects, (2) Perceived social support, and adapting to life after mastectomy. Our finding suggests that women who underwent mastectomy need holistic care including physical, psychosocial, and emotional support from their family, society, and healthcare professionals.

Effectiveness of Pre-discharge Educational Intervention Session in the Prevention of Arm Lymphedema Among Post-mastectomy Women in a Teaching Hospital in Bangalore, India.

Lymphedema is a severe post-mastectomy complication that still causes much morbidity in breast cancer patients with axillary lymph node dissection.Therefore, after mastectomy, lymphedema prevention is crucial for long-term survival and an increase in quality of life. Thestudy'sprimaryobjectivewastodeterminewhetherpre-dischargeeducationalinterventionsessions forpost-mastectomy women effectively improve the knowledge in preventing arm lymphedema. A quasi-experimental research study, one-group pretest-posttest design, was conducted in a teaching hospital in Bangalore.Thesampleincluded80females who were diagnosed with breastcancer,had recentlyundergone mastectomy,andhad chemoandradiationtherapy plans.Questions were based on the knowledge of lymphedema preventive concepts, including the definition of the lymphatic system and lymphedema, its causes, symptoms, prevention, and management, and were included in a structured self-administered questionnaire.Conveniencesampling was used among women who had undergone mastectomy for breast cancer.The pre-discharge educational interventions session included instructions on a self or simple lymphatic drainage technique demonstration, arm exercises, and an e-brochure on risk reduction strategies and arm lymphedema prevention. The knowledge of pre-discharge educational interventionsessions highlighting risk reduction/prevention strategies among post-mastectomy women was evaluated using the self-structured knowledge questionnaire pretest and posttest data. The entire study population comprised women who had undergone mastectomy.Almost half of the subjects were older than 55 years.Prior to the intervention, the majority of patients (58) had poor knowledge (72%) about preventing lymphedema, whereas nearly all patients (80) had good knowledge (100%) after the intervention sessions.All participants felt comfortable using the treatment plan to avoid arm lymphedema. The knowledge gain was statistically significant at the 0.05 level. It was determined that pre-discharge educational intervention sessions enhanced post-mastectomy women's awareness and risk reduction behaviors toward preventing arm lymphedema and reducing arm morbidity. Therefore, it is suggested that women who have had breast cancer surgery participate in a pre-discharge educational intervention program. This will guarantee that all mastectomy patients have access to educational information/materials and that risk reduction strategies are followed to prevent lymphedema.

A study to assess the effectiveness of video assisted teaching regarding impact on external breast prosthesis among post mastectomy women in a selected hospital at Kanyakumari District

The purpose of the study to assess the effectiveness of video- assisted teaching regarding impact on external breast prosthesis among post mastectomy women in a selected hospital at Kanyakumari District The purpose of the study was to assess the knowledge and attitude of post mastectomy women on external breast prosthesis before and after video assisted teaching. The study was conducted in International cancer center at Kanyakumari medical mission, Neyyoor. Purposive sampling technique was adopted. Samples were selected on the basis of inclusion criteria. Samples used were 30 post mastectomy women who were admitted at the International cancer center. The data collection tools developed for gathering the data, were a structured knowledge questionnaire to assess the knowledge of post mastectomy women regarding external breast prosthesis, five point likert scales to assess the attitude of post mastectomy women regarding external breast prosthesis. The study was based on the J.W Kenny” open system model. The research design adapted for this study was pre experimental one group pretest and posttest design. The feasibility of the study and the refinement of tools were assessed through pilot study. Findings of the study as follows in the pretest knowledge majority of the post mastectomy women that is 30(100.0%) had inadequate knowledge. In attitude the pretest of the post mastectomy women, 14(46.7%) were disagree, 12(40.0%) were uncertain, 3(10.0%) were strongly disagree, 1(3.3%) was agree and none of them had strongly agree. In the post-test, majority of the post mastectomy women that is 17(56.7%) had moderate knowledge, 11(36.6%) had adequate knowledge, and 2(6.7%) had inadequate knowledge. In the post-test, 16(53.3%) of the post mastectomy women were agree, 11(36.7) were uncertain, 2(6.7%) were strongly agree, 1(3.3%) were disagree and no one had strongly disagree. This study revealed that the video assisted teaching was effective in improving the knowledge and attitude on external breast prosthesis among post mastectomy women. Though knowledge and attitude of post mastectomy women were significantly improved with highest mean improvement, there was some lagging noted because of unavailability of adequate resources in the oncology unit. So we strongly recommend to conduct the in service education programme to upgrade the knowledge.

Lived experiences of post-mastectomy women: A qualitative study of Western Rajasthan.

Women's breasts have biological functions to lactate, socially and culturally seen as sensual, and the essence of her femininity. In the world, breast cancer is the most constantly occurring non-cutaneous cancer among women. The qualitative phenomenological study aimed to explore the lived experiences of post-mastectomy women. A total of 14 post-mastectomy women were recruited through non-probability convenience sampling based on data saturation, at the radiation unit of a tertiary care hospital, in Basni, Jodhpur, Rajasthan, from September to November 2020. The data was collected using an in-depth interview schedule. It was firstly audio-recorded and transcribed, and then themes and subthemes were extracted. Experiences of women were recorded and analyzed using Colaizzi"s framework (1978) and ATLAS ti. 9 scientific software. This revealed five main themes and their subthemes: Body image changes, physical impacts, emotional impacts, treatment impacts, and coping and support sources. In India, the lack of exploration regarding this topic is due to the stigmatization of very private parts, i.e., breast involvement and people rarely discuss it. Thus, there is a need for more such studies to be done, and more attention is required on the role of nurses to assist post-mastectomy women psychologically, spiritually, and physically to cope with their conditions. Findings highlight that mastectomy as a surgical treatment may negatively affect a woman's body image. It's highly recommended to address individual women's psychosocial needs and preferences before undergoing mastectomy in educational sessions by physicians involving nurses with them. Also, proper knowledge about reconstructive procedures should be provided to improve their body image. The counseling sessions can be conducted pre and post-mastectomy by a professional counselor.

Influence of Complex Physical Therapy on Physical Fitness and Balance in Women After Unilateral Mastectomy Due to Cancer Treatment

Introduction: As a result of mastectomy, physical fitness deteriorates, balance disorders and lymphoedema of the upper limb occur, which undoubtedly affect the level of stability among women following this surgery. Complex physical therapy in this group of patients is one of the key aspects influencing the level of physical activity among women subjected to surgery. Research objective: The aim of the study was to assess the impact of complex physiotherapy on physical fitness and balance in women following unilateral mastectomy with lymphoedema of the upper limb. Additionally, it was analysed whether wearing an external breast prosthesis affects the postural stability of women after mastectomy. Materials and methods: The study group comprised 30 women post unilateral mastectomy, 51 to 78 years of age, with upper limb lymphoedema. Before starting and after completing the physical therapy programme, the examined women were asked to perform the Timed Up and Go (TUG) Test and the Static Postural Stability Test on the Biodex Balance System platform. The tests were performed at the Posturology Laboratory of the Collegium Medicum, Jan Kochanowski University in Kielce. Results: In the analysis of the results of the Timed Up and Go Test in women following unilateral mastectomy, better results were noted after completion of physiotherapy in all 3 trials (p=0.001, p=0.021, p=0.004), as well as in the Postural Stability Test for all test parameters. The Mann-Whitney U test allowed to indicate a statistically significant difference in the values of the general stability index (p=0.005) and the A/P stability index (p=0.004). Greater body sway dominated in the sagittal plane than in the frontal one (A/P > M/L). On the other hand, in posturographic examination, external prostheses did not affect the postural stability of post-mastectomy women. Conclusions: 1. Systematic motor exercises in women following unilateral mastectomy are an important element of maintaining required physical activity, and they also prevent posture-related disorders; 2. The use of an external breast prosthesis in women after unilateral mastectomy does not significantly cause a change to body posture.

Effect of Compression Garment and Low Intensity Exercise on Upper Limb Function and Lymphedema among Post-Mastectomy Women: A quasiexperimental Two Arm Study

Effect of Compression Garment and Low Intensity Exercise on Upper Limb Function and Lymphedema among Post-Mastectomy Women: A quasiexperimental Two Arm Study

Progressive muscle relaxation technique effectiveness on pain and fatigue among post-mastectomy women

Background: Post-Mastectomy Pain (PPMP) and fatigue are common conditions that can follow surgeries for breast cancer, the most common cancer in women. The progressive muscle relaxation technique appears to be effective, affordable, low-risk, adaptable, and simple to use. Because of the frequency of PPMP and its potential severity, it has received increasing research attention. Aim: To evaluate the effectiveness of progressive muscle relaxation techniques on pain and fatigue among post-mastectomy women. Design: A quasi-experimental design was used to conduct this study. Setting: The study was conducted at the inpatient and outpatient clinic of Sohag Oncology institution. Subject: A purposive sampling technique was enrolled to select a sample of 50 post-mastectomy women who were randomly assigned into two equal groups, with 25 post-mastectomy women in each group (the experimental and control groups). Tools: Three tools were used (I) demographic data of Post mastectomy women sheet, (II) a Visual Analogue Scale, and (III) a fatigue assessment scale. Results: The current study revealed that the majority of post-mastectomy women in the intervention group experienced mild pain and fatigue reduction during the post-test compared to the control group.

Effect of instructional guidelines regarding post-operative activity and mastectomy exercises on breast cancer women's knowledge

Background: Women with breast cancer often are treated with some kind of surgery such as a mastectomy which affects moving the shoulder and arm or going about daily activities, like dressing, bathing, and combing hair. Pain and stiffness can cause weakness and limit movement of your arm and shoulder. Exercise can help get movement back. Aim: To investigate the effect of instructional guidelines regarding post-operative activity and mastectomy exercises on breast cancer women's knowledge. Design: A quasi-experimental design was used to accomplish this study (pre/post-test). Setting: The research will be carried out in the Oncology Inpatient and Outpatient clinic at Beni-Suef University Hospital, Egypt. Subject: The study subjects included a convenient sample of 100 women after mastectomy. Tools: Four tools were used Tool 1: Structured interviewing questionnaire: developed by the researchers to assess patient demographic, clinical data, and knowledge, Tool 2: Activities of Daily Living scales, Tool 3: The Pain Disability Index, and Tool 4: Observational checklist. Results: The results revealed that there was a positive significant correlation (P<0.001) between post-mastectomy women's knowledge scores pre and post-instructional guidelines implementation. There were highly significant improvements in post-mastectomy women's knowledge and post-operative activity and mastectomy exercises pre and post-instructional guidelines implementation (P<0.005).

Effect of Application Roy's Adaptation Model on Women's Satisfaction and Quality of Life after Mastectomy

Background: Breast cancer is the most common cancer and main cause of cancer death in women and nurses can provide holistic care through application of nursing models. Aim: To evaluate the effect of application Roy's adaptation model on women's satisfaction and quality of life after mastectomy. Design: A quasi- experimental design was utilized. Setting: The study was conducted on the Oncology department at Benha University Hospital and Health Insurance Hospital at Benha city, Egypt. Sampling: A Purposive sample included 100 women involving two groups (study and control). Tools: Three tools were utilized to collect data and included a structured interviewing questionnaire, Breast-QTM-Mastectomy Module and Roy's Adaptation Model. Results: there was a highly significant difference between study and control groups regarding total knowledge, total satisfaction and total quality of life after two weeks of program implementation and after three months of follow up (P ≤ 0.001).Also, there were high significant differences in all domains of maladaptive behaviors after the program implementation in the study group (P ≤ 0.001), while it was not significantly different in the control group. Conclusion: The application of Roy's adaptation model was effective on improving post mastectomy women's knowledge, satisfaction and quality of life also, promoted women's adaptation to the disease and treatment regimen. Recommendation: An educational program should be provided to all nurses on the oncology departments to promote their knowledge to educate women about disease and management.

Impact of Mastectomy on Quality of Life and Sexuality in Moroccan Women: About 100 Cases with a Mini Review of the Literature

It is well known that breast cancer treatment and especially mastectomy can affect body image, and sexuality of women with breast cancer, as well as to provide a general understanding of their quality of life .A descriptive exploratory study was conducted in department of Medical oncology in Morocco with a sample of 100 post mastectomy women. Disturbance of body image with loss of self-confidence was reported in 58% of our patients and the feeling of depression was found in 48% of the patients. Sexual unsatisfaction was reported in 50% of the patients. The results of this study could contribute to the medical oncologists and other physicians of the QOL and sexuel side of women with breast cancer.

Socio-Demographic and General Health Factors Associated with Quality of Life in Long-Term Breast Cancer Survivors from Southwestern Poland.

Background: Identification of factors associated with quality of life (QOL) in breast cancer survivors can contribute to better functioning in this group of patients. The study aimed to assess the association between QOL and anthropometric, sociodemographic, and medical characteristics in postmastectomy women from southwestern Poland, 9.4 (±6.5) years after completed treatment. Materials and methods: QOL was estimated with the SF-36v2 questionnaire in 250 survivors aged 62.8 (±8.0) years with previously histologically confirmed invasive breast cancer. Results: Women in this study rated their overall QOL with an average of 60.7 (±17.9), Mental Component Summary of 62.8 (±19.8), and Physical Component Summary of 57.5 (±18.8) points. The use of multivariate regression analysis revealed that depression, chronic diseases, abdominal obesity, and pregnancy history have a statistically significant negative effect on the QOL of women after mastectomy, whereas participation in regular physical activity, living with a partner, the education level ≥ 12 years, and living in the city were associated with a higher QOL assessment. There were no significant relationships between QOL and the age, time since surgery, type of treatment, smoking, and occupational status of the patients. Conclusions: Health education, greater social support, specialist care in the treatment of comorbidities, and propagation of a physically active lifestyle can improve the physical and mental functioning of breast cancer survivors long after diagnosis and treatment.

The impact of demographic factors on quality of life in women after breast cancer surgery.

Health is the main focus of studies on quality of life. Cancer can lead to changes in quality of life in postmastectomy women. The aim of this study was to examine the relation among sociodemographic factors and to assess the quality of life of women with breast cancer a year from their surgery. This single-center cross-sectional study included 104 participants (50 participants with mastectomy and 54 participants with quadrantectomy) aged from 37 to 72 years. The 36-Item Short Form Survey (SF-36) was used to assess physical, psychological, and social functioning of participants, as well as their sociodemographic factors and the clinical variables of the treatment. Participants with quadrantectomy aged up to 50 years had a significantly higher score when assessed in social functioning and mental/emotional health. Older participants expressed no significant differences in quality of life. Participants with quadrantectomy in all age groups had a higher score in social functioning, mental/emotional health, energy, and vitality than participants with mastectomy. A year from the surgery and cancer treatment, the quality of life of postquadrantectomy women was better compared to postmastectomy women.

Benefits of Lymphatic Drainage Manual In Lymphedema Treatment In Post-Mastectomy Women: Integrative Review

Benefits of Lymphatic Drainage Manual In Lymphedema Treatment In Post-Mastectomy Women: Integrative Review