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Personality traits and decision on breast reconstruction in women after mastectomy

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Miśkiewicz H., Antoszewski B., Iljin A.
Polish Journal of Surgery
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2016
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vol. 88(4)
209-214
EN
The aim of the study was evaluation of the correlation between selected personality traits in women after mastectomy and their decision on breast reconstruction. Material and methods. The study was conducted between 2013‑2015, in the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz, and Department of Oncological and Breast Surgery, CZMP. Comparative analysis comprised 40 patients, in whom mastectomy and breast reconstruction was done, and 40 women after breast amputation, who did not undergo reconstructive surgery. Basing on self-constructed questionnaire, five features of personality were evaluated in these women: pursue of success in life, ability to motivate others, openness to other people, impact of belonging to a social group on sense of security and the importance of opinion of others about the respondent. Apart from the questionnaire, in both groups of women a psychologic tool was used (SUPIN S30 and C30 tests) to determine the intensity of positive and negative emotions. Results. Women who did not choose the reconstructive option were statistically significantly older at mastectomy than women who underwent breast reconstruction. There were statistically significant differences between both groups in response to question on being open to other people and value of other people’s opinion. The differences in responses to question on the impact of belonging to a social group on personal sense of safety were hardly statistically significant. In psychometric studies there were significant differences in responses to SUPIN C30 test for negative emotions and S-30 for positive emotions. The level of negative emotions – feature of group A was in 47.5% in the range of high scores and in 47.5% within low and low-average scores. Among women from group B 57.5% had high scores, while 37.5% low and average scores. There were significant differences in the results of positive emotions evaluation in S-30. Women who did not undergo breast reconstruction usually had high scores, while those who decided on reconstructive surgery usually had low scores and low-high scores. Conclusions. 1. The decision on breast reconstruction after mastectomy is connected with personality features of patients. Introvert women, who base their self-opinion on opinion of others and their sense of security on belonging to a social group, rarely choose to undergo breast reconstruction. 2. Younger patients after mastectomy more frequently choose the breast reconstructive option. 3. A special algorithm of medical and psychological care in patients after mastectomy should be created to improve their further quality of life.
2
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Satisfaction with life and social factors in decision‑making process on breast reconstruction in women after mastectomy

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Miśkiewicz H., Antoszewski B., Woźniak E., Aleksandra l.
Polish Journal of Surgery
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2016
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vol. 88(5)
475-487
EN
The aim of the study was to analyse the correlation between satisfaction with life in women after mastectomy and motivation to undergo breast reconstruction, compared to women who after breast amputation did not decide to undergo reconstructive treatment. Material and methods. Comparative analysis comprised patients after mastectomy, who decided on breast reconstruction (40) and those who did not undergo reconstructive surgery (40). The study was conducted in the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz and Department of Oncological surgery and Breast Diseases ICZMP, Łódź, between 2013‑2015. In the study the question whether higher satisfaction with life prompts decision on breast reconstruction was investigated. The Satisfaction with Life Scale (SWLS) was used, as well as an original questionnaire. The correlations between statistical parameters were evaluated using the chi-square test. Results. We have demonstrated differences between the level of satisfaction with life in patients who decided to undergo breast reconstruction and those who did not choose reconstructive surgery. The discrepancies may reflect differences in the system of values and level of satisfaction with life before reconstructive treatment and also point to potential effect of these factors on the decision to undergo surgery. Conclusions. 1. Differences in cognitive structures between ‘Amazons’ determine the decision on reconstructive treatment. 2. Transfer of information between the therapeutic team and women after mastectomy is not satisfactory. 3. Higher level of satisfaction with life has a positive effect on the decision of breast reconstruction.
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Prace Oryginalne Original Papers Why Women Who Have Mastectomy Decide Not to Have Breast Reconstruction?

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Zieliński T., Lorenc-Podgórska K., Antoszewski B.
Polish Journal of Surgery
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2015
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vol. 86
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issue 10
451-455
EN
Breast cancer is the most common malignancy occurring in women. The treatment of breast cancer is a complex, multistep process involving surgical treatment, chemotherapy, radiotherapy, hormone therapy, targeted therapy, and very often rehabilitation. After the treatment of the underlying disease, or still in its course, there remains a problem of deformation of the chest. Although the number of women opting for breast reconstructive surgery increases every year, the number of such procedures in Poland is low. The aim of the study was to investigate the reasons why women after amputation of the breast due to cancer are not likely to undergo breast reconstructive surgery. Material and methods. The study comprised 73 women, residents of the province of Silesia, aged between 37 and 79 years, who had undergone mastectomy for malignancy in the years 1987-2013. Results. From all of the reasons given by women for refraining from breast reconstruction, the most frequently pointed was the fear of being subjected to further surgery (38.3%). 23 women (31.5%) admitted that they were also afraid of postoperative pain. Similarly, a common response (35.6%) was that it is not essential for their mental state, and 30% of respondents fully accepted their appearance after mastectomy. Concern about the effect of failed reconstruction was reported by 24.6% of the women, and the fear that the surgery could negatively affect the process of cancer treatment by 27.4% of respondents. Lack of information about the capabilities and knowledge of breast reconstruction methods was not an important factor in decision-making. Conclusions. Most of the surveyed women who abandon breast reconstruction surgery, make this decision on the basis of more than one reasons. Fear of undergoing a second surgical procedure and pain related to it were the most important reasons for the refusal of breast reconstruction. An important factor in the decision to desist from breast reconstruction is the age of the patients.
4
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Bilateral risk-reducing mastectomy – surgical procedure, complications and financial benefit

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Gierej P., Rajca B., Górecki-Gomoła A.
Polish Journal of Surgery
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2021
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vol. 93
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issue 3
48-54
EN
Risk-reducing mastectomy is a recognized prophylactic treatment for women at high and very high risk of breast cancer development in many countries. In surgical treatment, mastectomy with simultaneous reconstruction is preferred. The most common method is simultaneous reconstruction with the use of implants, but an equivalent method with a comparable or lower complication rate is simultaneous reconstruction with own tissues, taking into account free tissue flaps. The patient should be informed about the high risk of complications, possible deterioration of the life quality and high rate of corrective reoperations. In order for this form of the most effective and financially measurable health prophylaxis to be actually implemented, it is necessary to rationally evaluate the procedure and differentiate its costs depending on the type of reconstruction performed.
5
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BREAST-Q questionnaire: tool for evaluation of quality of life following breast reconstruction with DIEP/SIEA flap

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Ulatowski Ł., Noszczyk B.
Polish Journal of Surgery
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2018
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vol. 90(6)
1-5
EN
Breast cancer management is important for both oncologists and plastic surgeons. We can observe a considerable progress in knowledge and treatment modalities in this type of cancer. Treatment often requires reconstruction of the removed breast. Modern methods are becoming better and more suited to patient’s needs. At the same time, we observe a steadily increasing interest in quality of life after medical procedures. This tendency is particularly visible in plastic surgery, where simple analysis of complication rate is insufficient. In order to effectively help, a scrupulous evaluation of the outcomes by the patient herself is necessary. The aim of the study is to discuss and present the use of BREAST-Q questionnaire. It allows to assess patient’s satisfaction with the breast treatment as a whole and medical care. In this article, we present BREAST-Q questionnaire scores in 20 patients following secondary breast reconstruction with DIEP flap without rib removal when accessing internal mammary vessels. The assessment of quality of life is necessary for the reconstructive surgeon to evaluate his own work. It enables deeper understanding of needs and better advice for future patients during preoperative consultation. The results can also be useful for payers in order to decide about reimbursement of specific procedures.
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