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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2021

01-10-2021 | Mastectomy | Breast Oncology

Longitudinal Study of Psychosocial Outcomes Following Surgery in Women with Unilateral Nonhereditary Breast Cancer

Authors: David W. Lim, MDCM, MEd, PhD, Helene Retrouvey, MDCM, PhD, Isabel Kerrebijn, BS, Kate Butler, BSc, MHSc, Anne C. O’Neill, MBBCh, MMedSci, MSc, PhD, Tulin D. Cil, MD, MEd, Toni Zhong, MD, MHS, Stefan O. P. Hofer, MD, PhD, David R. McCready, MD, MSc, Kelly A. Metcalfe, RN, PhD

Published in: Annals of Surgical Oncology | Issue 11/2021

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Abstract

Introduction

Rates of bilateral mastectomy are rising in women with unilateral, nonhereditary breast cancer. We aim to characterize how psychosocial outcomes evolve after breast cancer surgery.

Patients and Methods

We performed a prospective cohort study of women with unilateral, sporadic stage 0–III breast cancer at University Health Network in Toronto, Canada between 2014 and 2017. Women completed validated psychosocial questionnaires (BREAST-Q, Impact of Event Scale, Hospital Anxiety & Depression Scale) preoperatively, and at 6 and 12 months following surgery. Change in psychosocial scores was assessed between surgical groups using linear mixed models, controlling for age, stage, and adjuvant treatments. P < .05 were significant.

Results

A total of 475 women underwent unilateral lumpectomy (42.5%), unilateral mastectomy (38.3%), and bilateral mastectomy (19.2%). There was a significant interaction (P < .0001) between procedure and time for breast satisfaction, psychosocial and physical well-being. Women having unilateral lumpectomy had higher breast satisfaction and psychosocial well-being scores at 6 and 12 months after surgery compared with either unilateral or bilateral mastectomy, with no difference between the latter two groups. Physical well-being declined in all groups over time; scores were not better in women having bilateral mastectomy. While sexual well-being scores remained stable in the unilateral lumpectomy group, scores declined similarly in both unilateral and bilateral mastectomy groups over time. Cancer-related distress, anxiety, and depression scores declined significantly after surgery, regardless of surgical procedure (P < .001).

Conclusions

Psychosocial outcomes are not improved with contralateral prophylactic mastectomy in women with unilateral breast cancer. Our data may inform women considering contralateral prophylactic mastectomy.
Appendix
Available only for authorised users
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Metadata
Title
Longitudinal Study of Psychosocial Outcomes Following Surgery in Women with Unilateral Nonhereditary Breast Cancer
Authors
David W. Lim, MDCM, MEd, PhD
Helene Retrouvey, MDCM, PhD
Isabel Kerrebijn, BS
Kate Butler, BSc, MHSc
Anne C. O’Neill, MBBCh, MMedSci, MSc, PhD
Tulin D. Cil, MD, MEd
Toni Zhong, MD, MHS
Stefan O. P. Hofer, MD, PhD
David R. McCready, MD, MSc
Kelly A. Metcalfe, RN, PhD
Publication date
01-10-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 11/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-09928-6

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