Summary
Although multiple benefits have been reported from post-mastectomy reconstruction
and particularly from an immediate procedure, limited psychiatric evaluation has been
published. The present study was planned to evaluate the psychosocial and psychopathological
outcome in patients who had undergone post-mastectomy breast reconstruction. We also
investigated if any psychopathological condition could significantly affect the benefits
of the reconstructive procedure. We compared 33 breast-reconstructed patients with
33 patients with mastectomy alone and 33 healthy women. All women underwent a psychiatric
interview with four questionnaire-based scales (SASS, QL-index, HAM-A, HAM-D) to assess
social adaptation, quality of life, anxiety and depression. A 4-point scale evaluated
reconstructed patients' satisfaction. After a year, there was no statistical difference
in social, sexual relationships and quality of life among reconstructed patients and
healthy women. Regarding anxiety, no statistical difference was found between reconstructed
and mastectomy groups. Statistically different lower depression levels in the healthy
group and higher levels in the mastectomy group were found. Depression in the reconstructed
group decreased compared to the mastectomy group. Differences between timing and reconstructive
techniques were not statistically validated. Eight patients were dissatisfied (24.2%).
Immediate reconstructed patients who had pre-existing major depressive disorder were
dissatisfied. Breast-reconstructed patients' quality of life, social and sexual relationships
are not significantly different to those of healthy women. Anxiety does not decrease.
Timing and techniques do not seem to influence, significantly, outcome and satisfaction.
Pre-existing diagnosis of major depressive disorder may be a contraindication to immediate
breast reconstruction.
Keywords
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Article info
Publication history
Published online: September 05, 2006
Accepted:
June 20,
2006
Received:
November 30,
2005
Footnotes
☆Presented in part at the VIIIth Congress of Italian and American Plastic Surgeons, Ischia, Italy, 6–8 June 2002 and at the British Association of Plastic Surgeons Summer Meeting, Newport, South Wales, UK, 2–4 July 2003.
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
