Breast cancer is the second most commonly diagnosed cancer in American women and around 12 percent of women will develop invasive breast cancer in their lifetime.1 Patients have the choice of 5 different types of mastectomy: total mastectomy with removal of breast tissue without lymph node removal, modified radical mastectomy where the entire breast and axillary lymph nodes are removed, radical mastectomy where entire breast and chest muscles are removed, partial mastectomy frequently referred to as breast conservative surgery where only cancerous tissue is removed, or subcutaneous mastectomy where breast tissue is removed with conservation of the nipple and areola.2 The standard of care in the United States for women who have had mastectomy secondary to breast cancer is to receive a breast reconstruction.2 On top of a common but devastating diagnosis of breast cancer with fears of facing months of chemotherapy and radiation, most women also make the decision to beat the cancer with a mastectomy and reconstruction.
The topic I am choosing for my literature review is the psychosocial effects after breast reconstruction in women who have chosen mastectomy as an intervention for breast cancer. I have always been very interested in going into the plastic surgery field when I become a provider and I believe researching this topic can help plastic surgeons and their staff provide appropriate patient education or advise that can result in the most favorable post surgical
Breast cancer affects one in every nine women in Britain, 45,000 women every year are diagnosed with it in some form or stage of development. Life style and cognitive interventions, i.e. counselling and psychotherapy can play an important part in how the patient deals with cancer in their lives and how they recover.
Depending on the time of diagnosis and the particular stage at which the cancer is present in the body, treatment options range from a mastectomy, chemotherapy, or surgery (Haas, 2008). A mastectomy is the surgical removal of the breast, it is an approach often taken to halt the spread of cancer cells to other parts of the body. Chemotherapy is an alternative to a treating the cancer. Chemotherapy for breast cancer is a systemic treatment, which affects most of the cells in your body. Most often chemotherapy is classified as the therapeutic use of chemicals to treat or control a particular disease. Potent drugs are used to kill or hinder the uncontrolled growth of cancer cells by interrupting their DNA, protein production, preventing cell division, starving them of their nutrients or blocking hormone receptors (Stephan, 2010).
As the long term outcome of radiation therapy was generally poor among the LRR occurring following mastectomy, His RA et al. had concluded that the long term survival as well as local control for loco regional recurrence of breast cancer after mastectomy were high among patients with favorable subgroup (1- DFS ≥2years, 2- isolated chest wall recurrence, 3- tumor size <3cm). They also find that this favorable subgroup of patients will reasonably benefit from aggressive treatment. (18)
One dependable source states, “Lumpectomy or partial mastectomy (also called breast-conserving surgery) followed by radiation therapy is generally considered to be as good as mastectomy for women diagnosed with early-stage breast cancer with an average risk of the cancer coming back (recurrence). Earlier research has shown that recurrence risk was about the same with either treatment” ("Removing”). There are multiple options that can be chosen to attempt to eliminate cancer that have been proven to have been effective in many cases.
Factors that determine how to treat breast cancer are stage and grade of tumor and if it has spread to other tissue in the breast. The sensitivity to hormones of the cancer cells, health of the patient, age of the patient, and preference of the patient. Treatment may include surgery, if surgery is necessary it may be in the form of a lumpectomy, mastectomy (total breast removal), biopsy of sentinel node, dissection of axillary lymph node, and breast reconstruction surgery if a mastectomy has been done. Lumpectomy surgery is the removal of the DCIS area and a margin of healthy tissue that surrounds it. If necessary lymph nodes under the armpit and total breast removal including the nipple and areola may be removed which is known a mastectomy. After this procedure has taken place further treatment may occur such as radiation in the form
II. A) Cdc.gov (2012) indicates, breast cancer is treated in several ways. It is depended on the kind of cancer and how far along it has spread. Treatment included surgery, chemotherapy, hormonal therapy, biological therapy and radiation.
agent, cisplatin may be effective treatment for hereditary BRCA1-mutated breast cancers . Another treatment for breast cancer is surgery. Surgery is usually the first line of attack against breast cancer. Before doing any surgery, doctors will ask patient about their medical record to ensure there is no complication during the process of surgery. There are several types of surgery such as lumpectomy, mastectomy, breast reconstruction and others. Lumpectomy is a surgery in which only the tumor and some surrounding tissue is removed. Mastectomy is a surgery that removes the portion, or segment, of the breast that contains the tumor. Breast reconstruction is an additional surgery to rebuild the breast. Breast reconstruction often can be done at
“When a woman first hears these four words, ‘you have breast cancer,’ her first thought are usually, ‘will I be strong enough to fight this disease?’ Once she learns that she will survive, thoughts about how she will confront drastic physical changes resulting from mastectomy and chemo are soon to follow.” (www.guide2breastcancer.com).
One experience where I received a lot of suffering for a significant period is when I found out that my mother got diagnosed with breast cancer. When my mother got diagnosed, the doctors said it was an early catch because there were no physical signs of it. They were surprised that my mother even felt any difference. Thank God, it wasn’t anything serious but at first, they didn’t know if it had spread, which caused me to break a little. I would wake up in the morning and see my dad sitting in the garage by himself just crying sometime, which also broke me even more because I haven’t ever really experience my dad in that type of stage. The only reason I started to deal with it was because my mom was so strong, she would tell me not to worry
Breast Cancer is one of the most common cancers in females. Breast is a very important organ for the females, especially with regards to cosmesis, femenity, social & emotional aspects. Loosing breast is a big trauma to a lady, it not only leads to emotional trauma and depression. But can also cause family &social disturbances. So in breast cancer, breast conservation surgery i.e. To save the breast, should be the moto, rather than mastectomy or removal of whole breast.
The participants in this research project were Jaqueline Jeruss and her husband Lonnie Shea. A person who gave an opinion and put their input on the project was Charusheela Andaz, a breast surgeon at Maimonides Medical Center in New York City. The research team were from the University of Michigan in Ann
“There are six different types of different types of breast cancer treatments being breast conserving surgery, lumpectomy surgery, partial
Although the findings of the study are very useful, there are still some limitations. The small, homogeneous sample size restricts the generalisability of this study to other stages of breast cancer and other phases of treatment. This sample also included women who were primarily from a single geographic area, which also restricts the applicability of the findings to other populations.
Studies done in the past have shown variable results. Several studies done have mainly looked at breast reduction. Only a few studies have examined postoperative changes in other cosmetic surgery procedures or have looked a several surgery types. There has been evidence suggesting that body image evaluation improves after breast reduction and augmentation surgery. In another study, results showed no significant improvement with cosmetic surgery.
The psychological outcome from cosmetic surgeries has a relationship with the effect on psychosocial or social parameters involved with one who has undergone cosmetic surgery. These parameters include work, social and sexual relationships. Patients who have undergone augmentation mammaplasty reported an improvement in their sexual relationships. Such patients who had a positive outcome from there cosmetic surgery procedure had increased self esteem therefore resulting in more social interaction. A study showed patients receiving a breast reduction taking a comprehensive psychosocial assessment before and after their surgery. Of the 33 patients who completed the survey, 20 patients were operated on and 19 were reassessed. Post surgery patients expressed high levels of satisfaction with