This presentation will provide an overview of the key psychosocial concerns of patients undergoing breast reconstruction, and the importance of early identification of patients at risk of distress, body image concerns and overall difficult adjustment.
The psychosocial issues associated with mastectomy are well documented. The purpose of breast reconstruction is to enhance psychosocial adjustment, and improve quality of life, by recreating the breast shape through a variety of surgical techniques.
There is a growing body of research exploring patient outcomes following mastectomy such as patient satisfaction, body image, sexual function, and quality of life. Adjustment to a change in body image is a psychosocial concern faced by many cancer patients who undergo surgery which results in changes to physical appearance and/or body functioning. Patients who undergo mastectomy are recognised as being a group vulnerable to body image difficulties, and therefore an important group to identify and support. Asking about body image or broader sexuality concerns, normalising these, and offering specialised support if required, are integral in the provision of care to patients undergoing breast surgery.
Recent research suggests that immediate reconstruction assists in mitigating body image distress and enhances psychological well-being post-operatively. Historically, the prevailing view was that delayed reconstruction facilitated the adjustment process by providing time for patients to grieve the loss of the breast before moving to acceptance of the new breast shape. Understanding patient expectations of breast reconstruction, their decision making process, and any potential factors impacting on this are important considerations to assist post-operative adjustment.