What patient characteristics fair the best with breast reconstruction?
Early detection and treatment of breast cancer in recent years has led to a longer survival of these patients. This in turn has led to an increased interest in the quality of life of breast cancer survivors. Although there is a paucity of literature about this facet of breast reconstruction, a newly published study looks at ‘quality of life’ parameters. According to a new study, certain personality traits are linked to higher quality-of-life scores in breast cancer patients who undergo breast reconstruction after mastectomy. (Plastic & Reconstructive Surgery. 127(1):10-17, January 2011)
The study investigators gave a battery of psychological tests to 57 women with breast cancer who underwent mastectomy and immediate breast reconstruction. The goal was to look at how various personality dimensions and patterns of interpersonal functioning affected quality of life after surgery.
After adjustment for other factors, two personality types were linked to higher quality-of-life scores. This included women with high scores for the temperamental characteristic of “harm avoidance” (i.e. patients who may be apprehensive and doubtful). For these patients, the authors note that restoration of their body image could help to reduce social anxiety and insecurity.
Patients rated as “vindictive/self-centered” on a scale of interpersonal problems also had higher quality-of-life scores. These type of patients may be resentful and aggressive. For many of them, the complete process of breast reconstruction might symbolize the conclusion of a reparative process and fulfill the desire of a “revenge on cancer.”
None of the other psychological or other factors evaluated including the characteristics of the cancer and its treatment were significantly related to quality-of-life scores. Overall, mastectomy followed by breast reconstruction yielded significant improvement in quality of life.
As survival rates improve, there is increased attention to the quality of life in breast cancer survivors. More women are undergoing breast reconstruction immediately after mastectomy, which seems to reduce the psychological impact of treatment. This new study is one of the first to look at how personality factors might affect patient satisfaction and quality of life after mastectomy and breast reconstruction. The results suggest that some personality characteristics have an important impact on psychological recovery after breast cancer treatment. This is likely true not only for patients who choose to have immediate breast reconstruction with autologous tissue or with tissue expanders, but also for patients that desire revision of previous sub-optimal breast reconstruction.
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