Psychological Impact of Mastectomy and Breast Reconstruction

The diagnosis and progression of cancer can be viewed as a traumatic event in the experiences of those who are affected and may cause fear of suffering, helplessness, disability and isolation. A substantial proportion of those who suffer from cancer express distress in the form of depression and hopelessness and a few number with loss of will to live or desire for hastened death. However, this could in turn affect their quality of life. In addition, the later may arise with inadequate relief of pain or other physical symptoms such as depression, hopelessness, social isolation or reluctance to depend on others for support Systematic review of both quantitative and qualitative published research articles comprising of cross-sectional, prospective, longitudinal and observational studies. Eight research papers examined psychological impact of mastectomy and breast reconstruction and found that body image disturbances, low self-esteem and altered sexuality were the major reactions that are experienced by breast cancer patients who underwent mastectomy while another seven studies examined the quality of life in patients following mastectomy and breast reconstruction. In all, a total of twenty research articles were reviewed. Findings indicate that the quality of life of post-mastectomy patients is influenced by the stage of the disease and a more advanced stage of the disease is significantly related to poorer quality of life, which is a reflection findings that quality of life of patients with stage 111 breast cancer was significantly lower than stage 1 or 11 breast cancer. Meanwhile, pain occurred on the majority of the participants, which is a partial explanation of why surgical approaches that attempt to improve the negative impact of radical mastectomy failed in translating its benefits of achieving better body image into a better quality of life. Anxiety, depression and hopelessness were independent predictors of the desire for hastened death which mediated the effects of psychosocial and disease related variables on this outcome. The risk factor identified, support a holistic approach to palliative care in patients with lung cancer, which inclines to psychological, physical and spiritual factors to prevent and manage distress in patients with terminal illness