Surgical Choices and Body Image
I was pleased to see this study from Breast Cancer Research Treatment about women's body image after breast cancer surgery. I will share the abstract and a link to read more, but the conclusion is that, after two years, there is no difference in positive body image among women who had a lumpectomy vs a mastectomy with reconstruction vs a mastectomy without reconstruction. In fact, in the shorter term, women who chose no reconstruction felt better about their bodies than those who had; those distinctions seem to be related to lengthy surgical healing and return to robust good health.
Whenever I meet with women who are struggling with this decision, I reassure them that, whatever choice they make, it will be the right one for them. I have been impressed through the years that all the women whom I have known have been satisfied (maybe not happy, but adapted) with their choice and new body. That has been true whether a woman opted for lumpectomy/radiation or a mastectomy with or without reconstruction. Even a few women who were totally traumatized at the time, eventually made peace with their decisions.
Effects of breast cancer surgery and surgical side effects on body image over time
Abstract We examined the impact of surgical treatments(breast-conserving surgery [BCS], mastectomy alone,mastectomy with reconstruction) and surgical side-effectsseverity on early stage (0-IIA) breast cancer patients' bodyimage over time. We interviewed patients at 4-6 weeks(T1), six (T2), 12 (T3), and 24 months (T4) following definitive surgical treatment. We examined longitudinal relationships among body image problems, surgery type, and surgical side-effects severity using the Generalized Estimating Equation approach, controlling for demographic, clinical, and psychosocial factors. We compared regression coefficients of surgery type from two models, one with and one without surgical side-effects severity. Of 549 patients enrolled (mean age 58; 75% White; 65% BCS, 12% mastectomy, 23% mastectomy with reconstruction), 514 (94%) completed all four interviews. In the model without surgical side-effects severity, patients who underwent mastectomy with reconstruction reported poorer body image than patients who underwent BCS at T1-T3 (each P\0.02), but not at T4. At T2, patients who underwent mastectomy with reconstruction also reported poorer body image than patients who underwent mastectomy alone (P = 0.0106). Adjusting for surgical side-effects severity, body image scores did not differ significantly between patients with BCS and mastectomy with reconstruction at any interview; however, patients who underwent mastectomy alone had better body image at T2 than patients who underwent mastectomy with reconstruction (P = 0.011).
The impact of surgery type on body image within the first year of definitive surgical treatment was explained by surgical side-effects severity. After 2 years, body image problems did not differ significantly by surgery type.
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