Quality of Life After Breast Cancer Surgery With or Without Reconstruction

Demetris Stavrou, MD; Oren Weissman, MD; Anna Polyniki, MD; Neofytos Papageorgiou, MD; Joseph Haik, MD; Nimrod Farber, MD; Eyal Winkler, MD


ePlasty. 2009;9:e18 

In This Article

Abstract and Introduction


In the modern era, where breast-conserving surgery is a viable alternative to mastectomy, breast cancer patients and their healthcare providers have to consider the issue of quality of life in regards to the type of surgery. The choice of surgical procedure should consider the perceptions of women diagnosed with breast cancer as well as their functional and emotional well-being. A more holistic approach to the patient should be implemented with proper psychological evaluation before and psychological support after the crisis.


Breast cancer is a major health issue in modern society. The National Cancer Institute estimates that 12.7% of women born today will be diagnosed with breast cancer during the course of their lifetime.[1] Breast cancer can impact patients psychologically as well as organically, which can manifest as postmastectomy depression, increased anxiety, shame, and occasional ideas of suicide.[2] Nowadays, breast-conserving treatments such as lumpectomy followed by radiation,[3,4] or breast reconstruction after mastectomy,[5] are viable alternatives to mastectomy alone, especially in early stages of the disease. Until the role of women in society and views on sexuality dramatically changed in the 60s and 70s of the 20th century, breast reconstruction was considered merely vain[6] and performed in a troubled subset of cancer patients.[7] Fortunately, this view has changed in recent decades, resulting in an ever-growing increase in patients choosing breast-conserving surgery or breast reconstruction. This trend has spawned efforts to assess the efficacy of these treatment modalities, taking into account not only mortality rates and reconstructive techniques but patients' satisfaction rates and quality of life (QOL) as well. As Donabedian argued more than 30 years ago, the ultimate valuator for quality of care is its effectiveness in achieving or producing health and satisfaction.[8] In other words, care cannot be of high quality unless the patient is satisfied. In today's increasingly competitive healthcare marketplace, the issue of measuring the quality of care given to patients, as well as the QOL they derive from it, has become a topic of considerable interest and controversy among healthcare providers as well as patients. In this work, we attempt to highlight the perceptions of breast cancer survivors in regards to changes in their QOL after being diagnosed with breast cancer, as well as following their medical treatment, including surgery, chemo-radiotherapy, or both. The concept of body image, which is closely related to health-related QOL, will also be discussed.


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